Gluteus Medius Tendinopathy

A 57-year-old woman presented with right hip pain. The initial diagnosis was an inflammatory tendinopathy of the gluteus medius without signs of rupture, and the patient underwent an ultrasound-guided corticosteroid injection. However, 1 month later, she presented with a painful swelling on the anterior-external aspect of the right hip/thigh, with a clinical suspicion of malignancy. Magnetic resonance imaging (MRI) scan and ultrasound confirmed the diagnosis of hypertrophy of the tensor fascia lata (TFL) muscle ...

INTRODUCTION: Tendinopathy and tendon tears of the gluteus medius and/or minimus (GMM) insertion at the greater trochanter are increasingly recognised internationally as a cause of recalcitrant lateral hip pain (LHP). The purpose of this study was to report the first Danish results of open surgical repair of GMM tears in female patients. METHODS: In this retrospective observational study, we included 67 women (68 hips) with a mean (95% confidence interval (CI)) age of 59 (56-61) years who underwent open GMM repair between September 2018 and June 2022...

OBJECTIVES: To investigate the efficacy and safety of ultrasound-guided percutaneous irrigation of calcific tendinopathy (US-PICT) applied out of the shoulder, comparing its effectiveness to US-PICT of the rotator cuff. METHODS: Patients subjected to US-PICT for extra-shoulder calcific tendinitis (Case Group) were compared to those subjected to US-PICT of the rotator cuff (Control Group). We had pre-procedure Visual Analogue Scale (VAS) pain score, 1- and 3-month VAS of patients of the Case Group, pre-procedure and 3-month VAS of patients of the Control Group...

Calcific tendinopathy in the gluteus medius is uncommon and sporadically reported. It may be asymptomatic or present with acute or chronic pain. Pain is usually isolated to the lateral hip overlying the gluteal muscles or greater trochanter. We present a rare case of gluteus medius calcific tendonitis as a cause of severe anterior hip pain. Given the atypical local and clinical presentation these can be often misdiagnosed as septic arthritis or fracture which may lead to overtreatment and even unnecessary surgery...

AIMS: To identify and highlight pertinent US features that could serve as imaging biomarkers to describe different patient phenotypes, within Great Trochanteric Pain Syndrome (GTPS) clinical diagnosis. MATERIALS AND METHODS: Using ultrasound we evaluated eighty-eight clinically diagnosed patients with GTPS, for tendon matrix changes and calcium deposits in the gluteus medius (superoposterior and lateral aspects) and in the gluteus minimus. Peritrochanteric examination included fascia lata, trochanteric bursa, cortical irregularities and the presence of enthesophytes...

Gluteal tendinopathy is a common source of impairment in adults due to degenerative changes in the gluteus medius tendon. We identified patients with gluteal tendinopathy who underwent surgery with a minimum six-month follow up. Radiographs, magnetic resonance images, demographic data, Hip Outcome Score (HOS), Veterans Rand 12-item health survey (VR-12), and a patient survey were reviewed. The cohort consisted of seventeen complete tears and thirty-one partial tears of the gluteal medius tendon (n = 48). Of patients, 72...

Diagnosing buttock pain is a challenge due to complex anatomy and multiple causes. Potential pathologies range from common and benign to rare and life-threatening. Common causes for buttock pain include referred pain from the lumbar spine and sacroiliac joint, hamstring origin tendinopathy, myofascial pain, ischiogluteal bursitis, gluteal pathology, and piriformis syndrome. Rarer causes include malignancy, bone infection, vascular anomalies, and spondyloarthropathies. Other conditions may be present concurrently in the lumbar and gluteal area, which can cloud the clinical picture...

BACKGROUND: The best treatment of degenerative hip abductor tendon lesions remains largely unknown, as the natural course of the disease has not yet been reported. The aim of the present study was to investigate the natural history of symptomatic degenerative hip abductor lesions. HYPOTHESIS: Nonoperatively treated hip abductor lesions progress over time, resulting in refractory hip pain and low functional outcomes. STUDY DESIGN: Case series (prognosis); Level of evidence, 4...

Tears in the gluteus medius and minimus tendons are a common cause of greater trochanter pain syndrome (GTPS). Given the non-specific clinical signs and imaging findings, they are often misdiagnosed, with delayed treatment. The lesions can show several aspects: trochanteric bursitis, simple tendinopathy, partial or full-thickness tear, tendon retraction, or fatty degeneration. Non-surgical treatment associates physical rehabilitation and activity modification, oral analgesics, anti-inflammatories and peri-trochanteric injections (corticosteroids, PRP)...

PURPOSE: The primary purpose of this study was to systematically review the literature on intraoperative findings during endoscopic treatment for GTPS. Secondary outcomes were preoperative imaging findings and postoperative functional outcome measures. METHODS: Medline, PubMED, and Embase databases were searched from inception (1946, 1966, 1974 respectively), to July 15, 2021 for records reporting intraoperative findings during endoscopic surgery for GTPS. Studies of level I-IV evidence were eligible...

OBJECTIVE: This study aims to describe a simple and accurate semiological method executing a specific maneuver with the lower limb to direct the semiological investigation towards the tendinopathies in the gluteus medius and minimus. METHODS: Fifty patients participated in the study, with a mean age of 44.1 ± 13 years, with persistent pain on the side of the hip for more than three months. To compare the FABREX (proposed test) and Lequesne semiological tests, in the diagnosis of tendinopathies in the gluteus medius and minimus, Magnetic Resonance Imaging (MRI) was adopted as the gold standard...

INTRODUCTION: Greater trochanteric pain syndrome may often mimic pain generated from other sources. However, it is most commonly caused by gluteus medius and gluteus minimus tendinopathy or tear. The purpose of this technical report was to: 1) describe the ultrasound-guided fascial plane block technique targeting the superior gluteal nerve in the plane between gluteus medius/gluteus minimus to treat moderate-to-severe, chronic, refractory greater trochanteric pain syndrome; 2) anatomically correlate the procedure with cadaveric dissections demonstrating the structures being imaged and the tissues along the needle trajectory; 3) demonstrate the feasibility of the technique with serial dissection of one cadaveric specimen following injection with color dye...

BACKGROUND: Patients with gluteus medius tendinopathy present with laterally based hip pain that can be diagnosed under the greater trochanteric pain syndrome diagnosis. Magnetic resonance imaging (MRI) can assist in diagnosing pathology of the symptomatic hip, and when a pelvic MRI that includes both hips, the clinician may identify asymptomatic tears in the nonsurgical hip. In patients who undergo unilateral gluteus medius repairs, little is known about the prevalence or subsequent onset of clinical symptoms in the nonsurgical hip...

INTRODUCTION: To date, there exists no gold standard conservative treatment for lateral hip pain due to tendinopathy of the gluteus medius and/or minimus tendon (GT), a condition often complicated by pain and disability. Higher loads during everyday activities and exercise seems to be contraindicated with GT. The purpose of this study was to evaluate the feasibility of exercise with low-loads concurrent partial blood flow restriction (LL-BFR) and patient education for patients present GT...

Purpose: To compare the repair strength, gap formation, and mode of failure between endoscopic and open double-row gluteus medius repairs in a cadaveric model. Methods: Six pairs of fresh-frozen human cadavers were used in this study. Gluteus medius tears were created in an open fashion and then repaired with either open or endoscopic techniques. Specimens were manually preloaded to 5 N, then cycled between 20-50 N for 150 cycles s. Then, a ramp to/s. Specimens were then returned to 10 N and ramped to failure at 1 mm/s...

UNLABELLED: Greater trochanteric pain syndrome (GTPS) refers to pain in the lateral hip and thigh and can encompass multiple diagnoses including external snapping hip (coxa saltans), also known as proximal iliotibial band syndrome, trochanteric bursitis, and gluteus medius (GMed) or gluteus minimus (GMin) tendinopathy or tearing. GTPS presents clinicians with a similar diagnostic challenge as non-specific low back pain with special tests being unable to identify the specific pathoanatomical structure involved and do little to guide the clinician in prescription of treatment interventions...

BACKGROUND: Increasing evidence supports surgical intervention for hip abductor tears; however, the influence of fatty infiltration (FI) on outcomes after repair remains uncertain and has been addressed only in small case series. PURPOSE: To clarify the relationship between FI and surgical outcomes for hip abductor tears. STUDY DESIGN: Meta-analysis; Level of evidence, 4. METHODS: A systematic review and meta-analysis was conducted according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines...

Calcific tendonitis of the gluteus medius and minimus tendons is a rare complication of hydroxyapatite deposition disease, with bilateral involvement even more so. Although patients can be asymptomatic, there is often an acute-on-chronic presentation of pain. We present a case of bilateral calcific tendonitis of the gluteus medius and minimus tendons on a background of previous bilateral rotator cuff calcific tendonitis in a middle-aged woman. This patient's long-standing history of multi-focal involvement required a multidisciplinary approach between orthopedics, rheumatology, and musculoskeletal radiology for optimal management, requiring different treatment options for different affected sites...

INTRODUCTION: Greater trochanter pain syndrome (GTPS) is characterized by a persistent and debilitating pain around the greater trochanter. GTPS can be caused by a combination of gluteus medius or minimus tendinopathy, snapping hip or trochanteric bursitis. SOURCE OF DATA: Recent published literatures identified from PubMed, EMBASE, Google Scholar, Scopus. AREAS OF AGREEMENT: Platelet rich plasma (PRP) and corticosteroids (CCS) injections are useful options to manage symptoms of GTPS...

INTRODUCTION: There are many studies on the Greater Trochanteric Pain Syndrome (GTPS), however its relationship with radiographic and biomechanics parameters is not established. OBJECTIVE: To compare the magnetic resonance images (MRI) of the hip, radiographic parameters of sagittal alignment (pelvic incidence, sacral slope and lumbar lordosis), muscular strength and endurance in women with and without GTPS. METHODS: Forty women, age over 45, IMC <30 Kg/m2 and sedentary, were recruited and distributed in two groups: GTPS group (GTPSG, n = 20) and Control group (CG, n = 20)...