MRI Hip Gluteal tendons. This post reviews the various abnormalities seen of the gluteal tendons from tendinosis and tears to the feature of avulsion.

Image Above: Gluteus minimus tendinosis ( blue arrow) with ill definition and mild increased signal of the tendon. Peri tendinosis which is inflammatory change around the tendon ( yellow arrow). Small amount of fluid in th sub gluteus medium bursa ( red arrow).  

Image Above: Partial tear posterior fibres of gluteus medius ( yellow arrow). Interruption of black tendon fibres with fluid signal indication fluid accumulating in a tear. 

 

3 Features of a Complete Tear and Avulsion:

1. Bare Facets
2. Tendon Laxity
3. Muscle atrophy

 

Image Above: Complete tear and avulsion resulting in bare facets ( no tendon attachment seen) of gluteus minimum ( yellow arrow), anterior fibres of gluteus medium ( red arrow). Posterior fibres of gluteus medium ( blue arrow) still attached but demonstrate tendinosis with mild increased signal.

Image Above: Image on right demonstrates laxity of the anterior gluteus medium tendon ( yellow arrow) which indicates that there has been rupture of the fibres from their attachment.  Compare with normal taut tendon on left. 

Image Above: Atrophy of the gluteus minimum muscle ( image on right yellow arrow) compare with normal on left image. Significant atrophy like this usually indicates underlying rupture of the tendon.