Body Wise – Gluteus medius tendinopathy/trochanteric bursitis

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MR Scan of the pelvis showing swollen trochanteric bursa as a bright white region adjacent the greater trochanter.

MR Scan of the pelvis showing swollen trochanteric bursa as a bright white region adjacent the greater trochanter.

Gluteal tendinopathy is the most common hip tendonitis (hip tendon injury). Athletes who are prone to gluteus medius tendinopathy include long-distance runners. Over the last few years I have also seen this problem in cricketers (bowlers only).

Typical symptoms are hip pain on climbing stairs, getting out of a car or on standing up from a low chair.

The gluteal or buttock muscles extend from the bony pelvis to the proximal femur (thigh bone). They extend or straighten the thigh at the hip.

Gluteus medius is attached to the greater trochanter. The trochanteric bursa overlies gluteus medius allowing movement against adjacent structures.

Gluteus medius tendinopathy and trochanter bursitis are, in general, more common in women than men. It is most likely that this female predisposition relates to the shape of the female pelvis, with hip joints further apart than in males. The wider hips and overall shape of the pelvis put stress on the gluteus medius insertion.

hippetergendall2While this is often an overuse injury (typically in women over the age of 50) we also see gluteus medius tendinopathy occurring acutely as a result of a fall on the hip or a severe knock on the hip or, perhaps more precisely, the greater trochanter.

Treatment involves initial rest from activities that aggravate the pain, stretching and strengthening. Corticosteroid injection is quite often required and ultrasound is most helpful in guidance, giving an exact diagnosis and allowing this injection to be placed precisely.

www.riverradiology.co.nz

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