Tendinosis and tears of gluteus medius and minimus muscles as a cause of hip pain: MR imaging findings

OBJECTIVE. This study was conducted to determine the prevalence of tendinos is and tears of gluteus medius and minimus muscles in patients presenting w ith buttock, lateral hip, or groin pain; describe the MR imaging findings; and discuss their probable relationship to the greater trochanteric pain sy ndrome. SUBJECTS AND METHODS. Two hundred fifty MR imaging examinations of the hip were performed for the evaluation of buttock, lateral hip, or groin pain. T he findings were reviewed for changes in the morphology or signal intensity of gluteus medius and minimus muscles and tendons and for any peritendinou s abnormality including distention of regional bursae. RESULTS. Thirty-five studies met our criterion of showing either tendinosis or tears of gluteus medius and minimus muscles as the primary positive fin ding. Eight patients had complete retracted tears of the gluteus medius, an d 14 patients had partial tears; in 13 patients, MR findings were consisten t with tendinosis. The gluteus minimus muscle was also involved in 10 patie nts. MR imaging findings were the same as those described for tears and ten dinosis of other regions of the body. Surgical proof of a tendon tear was o btained in six patients. CONCLUSION. Tendinopathy of the hip abductors and gluteus medius and minimu s muscles was a common finding on MR imaging in our patients with buttock, lateral hip, or groin pain. Tendinopathy is probably a frequent cause of th e greater trochanteric pain syndrome, a common regional pain syndrome that can mimic other important conditions causing hip pain including avascular n ecrosis and stress fracture. Moreover, it is likely that trochanteric bursi tis is associated with tendinopathy.