Case Challenge

Hip & Thigh

Stephen J Pomeranz

Gain confidence interpreting Hip MRI with practice cases from MRI Online. Quiz yourself using real-world DICOMs & earn CME. Try it free!

Case Review

Musculoskeletal (MSK)

Post-Course Activities

This Power Pack is comprised of 25 unique Hip MRI cases that you can scroll through in our diagnostic web viewer to determine your findings. Quiz yourself and earn CME.

Hip MRI Cases

Case 14 - 90-year-old male presents with left hip pain

<div>HISTORY:&#160;This 90-year-old male presents with left hip pain. No known injury.PRIMARY FINDING:&#160;Full thickness tear of the gluteus medius tendon.Using the&#160;diagnostic web viewer, we have provided images that assist in telling our clinical story. Areas of significance are indicated below.FINDINGS: No recent macrofracture or bony contusion identified.&#160;Severe volumetric atrophy and fatty infiltration of the gluteus minimus. Myoedema of the gluteus medius along with partial fatty infiltration and incomplete rupture of the tendon from its greater trochanteric insertion without substantive retraction. Secondary gluteus medius and maximus bursitis involving superomid (gluteus medius) and posterior (gluteus maximus) bursae.&#160;Iliopsoas and other tendons about the left hip are intact. Hamstring origins are unremarkable.&#160;Generalized, mild narrowing of the weightbearing aspect of the left hip along with mild spurring of the acetabulum and femoral head. Chondromalacia is mild to moderate. No substantive joint effusion. Ligamentum teres is attritional, but intact. Transverse ligament, ilio- and ischiofemoral ligaments are intact. Mild capsulitis.Ossification of the acetabular labrum is noted. Chronic tear of the anterior/superior labrum. No substantive joint effusion.&#160;Partially-visualized prostate demonstrates enlargement.&#160;Substantive subcutaneous edema at the lateral aspect of the pelvis.&#160;CONCLUSION:&#160;1. Acute-subacute incomplete but full thickness tear of the gluteus medius tendon. Posterior fibers separated approximately 1.5 cm.2. Mild degenerative arthrosis of the left hip along with ossification of the acetabular labrum and chronic tear of the anterior/superior aspect. Secondary gluteus medius and maximus bursitis involving superomid (gluteus medius) and posterior (gluteus maximus) bursae.3. No recent macrofracture or bony contusion.&#160;4. Small capsulitis of the left hip.5. Severe volumetric atrophy and fatty infiltration of the gluteus minimus.</div>

Case

Full thickness tear of the gluteus minimus tendon

Full thickness tear of the gluteus medius tendon

Full thickness tear of the gluteus maximus tendon

Full thickness tear of the piriformis tendon

What is the primary finding in this case?