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Wk 3, Case 2 - Review

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Report

Patient History: 48 year-old male with left hip pain.
Findings
SKELETAL: Very subtle irregularity of the greater tuberosity or trochanter of the femur is noted best seen on series 501, image 9.

PELVIS: Normal.

JOINTS: Normal for age.

ACETABULUM/LABRUM: No traumatic labral tear.

MUSCLES/TENDONS/LIGAMENTS: Diffuse swelling around the gluteus minimus as it approaches the anterior facet of the greater trochanter of the femur is noted. A cystic delamination tear involves the interstitium of the insertion best seen in the axial projection. Diffuse swelling anterior to it.

The mid to anterior fibers of the gluteus medius footprint on the middle facet but relatively sparing the superior facet are noted with associated inflammation, and peritendinous swelling.

Gluteus maximus insertion is normal. Posterior facet of the greater trochanter is normal.

The ligamentum teres, transverse acetabular ligament, and iliofemoral ligament are normal.

Adductors, hamstrings, hip flexors are normal.

OTHER/SOFT TISSUE: Unremarkable apart from above.

Conclusion
1. Gluteus minimus and medius tears as described above.
2. Associated peritendinitis and bursitis involving the middle facet and anterior facet bursa.

Case Discussion

Faculty

Stephen J Pomeranz, MD

Chief Medical Officer, ProScan Imaging. Founder, MRI Online

ProScan Imaging

Jenny T Bencardino, MD

Vice-Chair, Academic Affairs Department of Radiology

Montefiore Radiology

Edward Smitaman, MD

Clinical Associate Professor

University of California San Diego

Tags

Musculoskeletal (MSK)

MRI

Hip & Thigh

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