A case of hip rotator cuff tear revealed by refractory gluteus medius tendinosis

We report a case of gluteus medius tear in a patient who presented with an 11-month history of severe trochanteric pain. Neither magnetic resonance im aging nor ultrasonography visualized the tear, the only findings being infl ammatory thickening of the tendon and bursitis. A glucocorticoid injection into the bursa under fluoroscopic guidance and three glucocorticoid injecti ons at the contact of the tendon failed to relieve the pain. At surgery, a 2 x 4 cm tear was found in the tendon of the right gluteus medius muscle. P artial tendon reconstruction was followed by prompt and lasting pain relief , in accordance with the few similar reports in the literature. This paucit y of publications is in sharp contrast with hip fracture surgery findings, suggesting that at least 10% of patients older than 60 years of age may hav e painless hip rotator cuff tears. (C) 2001 Editions scientifiques et medic ales Elsevier SAS.