James Andrew Letts FRANZCR, Presenter: Nothing to Disclose

Ross Peter Vernon McKellar MBChB, Abstract Co-Author: Nothing to Disclose

Elton R. Edwards MBBS, Abstract Co-Author: Nothing to Disclose

John Pike MD, Abstract Co-Author: Nothing to Disclose

Frank Anthony Malara MBBS, Abstract Co-Author: Nothing to Disclose

Tears of the hip abductor tendons [gluteus medius and gluteus minimus], as opposed to trochanteric bursitis, are increasingly believed to be the leading cause of greater trochanteric pain syndrome. The purpose of this study was to determine the accuracy of MRI in diagnosing tears of the hip abductor tendons in patients presenting with greater trochanteric pain syndrome.

28 hip MRI investigations performed between September 2000 and October 2006 in patients presenting with greater trochanteric pain syndrome and subsequently undergoing MRI evaluation and surgery were retrospectively reviewed. All patients [3 male, 24 female; age range 50-82 years, mean age 63] were scanned at 2 institutions using standardised protocol and images were interpreted by 3 radiologists experienced in musculoskeletal MRI. There was one female patient who had MR imaging and surgery on both hips. Mean time from MRI evaluation to surgery was 14 weeks [range 1 day-14 months].

23 tears were identified at MRI and subsequently confirmed at surgery [23/28 or 82%; 18 involving gluteus medius and 5 involving both gluteus medius and gluteus minimus, with no isolated gluteus minimus tears]. 5 MRI scans reported no tear; 3 of these were subsequently found to have a tear at surgery [3/28 or 11%] and the remaining 2 were confirmed as no tear [2/28 or 7%]. There were no false positive MRI scans. Accuracy of MRI for the diagnosis of tears of the abductor tendons of the hip was 89%. Sensitivity and specificity were 88% and 100% respectively.

MRI shows good accuracy [89%] for the diagnosis of tears of the gluteus medius and gluteus minimus tendons in patients presenting with greater trochanteric pain syndrome. This impacts on clinical care of these patients as the presence of a tear on MR imaging, along with clinical evaluation, is a determining factor leading to surgery.

MRI can demonstrate tears of the hip abductor tendons and is recommended in the evaluation of patients presenting with greater trochanteric pain syndrome, particularly prior to surgery.

Letts, J, McKellar, R, Edwards, E, Pike, J, Malara, F, Tears of the Hip Abductor Tendons: Diagnostic Accuracy of MR Imaging.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5010100.html