MR of tendons about the hip: A study in asymptomatic volunteers

Grove, Veerle De; Buls, Nico; Vandenbroucke, Frederik; Shahabpour, Maryam; Scafoglieri, Aldo; Mey, Johan De; Maeseneer, Michel De

doi:10.1016/j.ejrad.2021.109876

Cited by 4 publications

(4 citation statements)

References 7 publications

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“…The most common site for large enthesophyte formation was the hamstring origin at the conjoint biceps-semitendinosus tendon (29% of patients). Their presence may correspond to the high signal intensity changes commonly seen in asymptomatic individuals on MRI [7,8,9].…”

Section: Discussionmentioning

confidence: 92%

“…Steinert L et al [6] examined the association between trochanteric irregularities on radiographs and abnormal abductor tendon ndings on hip MRI, which differs from our study as it was based on symptomatic patients. A common belief among radiologists is that bony irregularities indicate pathology of the inserting tendons [7][8][9]. For example, in the rotator cuff, this concept has been debated many years.…”

Section: Discussionmentioning

confidence: 99%

“…separate study. Our study was based on ndings from CT alone, but we know from previous work that signal alterations in tendons on MRI do not necessarily correspond to pain symptoms either [7].…”

Section: Declarationsmentioning

confidence: 99%

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Enthesopathy and Calcifications around the Hip: Should these be Considered Normal Variations?

Grove

Roose²,

Hendrickx

et al. 2023

Preprint

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Purpose: Calcific tendinopathy, heterotopic ossification, enthesopathy, and bone erosions are common findings around the hip. These findings, which are typically seen at tendon attachments, may not always be associated with symptomatic disease. Therefore, in this study, we aimed to investigate the prevalence of these findings at eight separate tendon sites around the hip in an asymptomatic population. Material and methods: Our study included 50 patients who underwent a pelvic CT examination for a non-musculoskeletal indication. The patients completed a questionnaire to exclude any hip or pelvic pain, any prior trauma within the hip or pelvis, or any known rheumatological conditions. Two upper-level residents (PGY-4), who received specific training to identify enthesophytes, linear and round calcifications, bone erosions, geodes, and heterotopic bone, independently interpreted the transverse images in a bone kernel. The residents evaluated 8 separate tendon sites around the hip, including: the origins of the conjoint tendon (biceps femoris and semitendinosus) and semimembranosus at the ischial tuberosity; peritrochanteric insertions of gluteus minimus, gluteus medius, and gluteus maximus; the origins of tensor fascia latae and the direct head of rectus femoris; and the insertion of the iliopsoas tendon at the lesser trochanter. At each site, round calcifications, linear calcifications, bone erosions, and enthesophytes were identified, measured, and placed into an appropriate group based on size (< 1mm, 1-5mm, 5-10mm, > 10mm). Descriptive analysis and intraclass correlation coefficients were calculated. Results: The study included 50 patients, 22 men and 28 women, ranging in age from 24 to 94 years (mean age, 61 years). Enthesophytes, which were the most common finding at all the tendon sites, were typically small (< 5 mm); however, larger (> 10 mm) enthesophytes were found at all eight sites. Although less common, linear and round calcifications and erosions were seen at nearly all sites. Geodes, osteophytes, and heterotopic ossification were not identified at any of the investigated sites. The interobserver correlation was good with a calculated intraclass correlation coefficient of 0,697 (95%CI: 0,618-0,759). Conclusion: Enthesophytes are often observed at tendon insertion or origin sites around the hip and are typically asymptomatic, even when larger than 10 mm in size. While calcifications and osseous erosions are less common than enthesophytes, they are also present at nearly all the tendon sites around the hip in asymptomatic populations. Much like enthesophytes, their presence alone should not be attributed to clinical symptoms.

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

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Enthesopathy and Calcifications around the Hip: Should these be Considered Normal Variations?

Grove

Roose²,

Hendrickx

et al. 2023

Preprint

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“…The excessive hip adductions adopted during static postures and dynamic activities result in an excessive accumulation of compressive tendon loading of hip abductor mechanisms. Higher ranges during hip flexion may also change the ITB tensioning muscles; in fact, the confluence of the ITB with the gluteal fascia into the lumbodorsal fascia contributes to the gluteus medium tendon compression [ 4 , 23 , 30 ].…”

Section: Discussionmentioning

confidence: 99%

Satisfactory results after endoscopic gluteus medius repair combined with selective gluteus maximus reflected tendon release for the treatment of a full-thickness tear of gluteus medius

Rocca

Francia

Giuffrida

et al. 2022

Knee Surg Sports Traumatol Arthrosc

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Purpose The current study aimed to report the mid-term follow-up results of endoscopic gluteus medius repair combined with a systematic release of the gluteus maximus reflected tendon. Methods Twenty-two patients with a symptomatic full-thickness tear of the gluteus medius tendon, as diagnosed by clinical examination and imaging (MRI), and who had a failure of conservative treatment for at least 6 months, were retrospectively enrolled for this study. An endoscopic repair of gluteus medius was performed for all patients in combination with gluteus maximus reflected tendon release according to the Polesello technique. The Visual Analogue Scale (VAS) for pain, Modified Harris Hip Score (mHHS), Lower Extremity Functional Scale (LEFS), Hip Outcome Score-Activity Daily Life (HOS-ADL), and Hip Outcome Score-Sport Specific Subscale (HOS-SSS) were administered to each patient before surgery for 6 months, 1 year, and every following year after surgery. Results All analysed hip scores (mHHS, LEFS, HOS-ADL, and HOS-SSS) showed statistically significant improvements between the pre-operative and post-operative values at 6 months, 1 year, and the latest follow-up appointments after surgery (p < 0.001). The mean pre-operative pain was 8.6 ± 1.0 on the VAS. After surgical treatment, the pain was significantly reduced (p < 0.001) on the VAS at 6 months (5.4 ± 1.5), 1 year (4.4 ± 1.8) and the latest follow-up control visit (3.6 ± 2.2). No patient-reported major complications (re-rupture, deep infection or neurovascular injury). Eleven (50%) patients indicated the results as excellent, 7 (32%) as good, 2 (9%) as fair, and 2 (9%) as poor. Conclusion The use of abductor tendon repair in combination with a systematic release of the reflected tendon of the gluteus maximus according to the Polesello technique seems to be a safe and effective endoscopic way of treating a full-thickness tear of the gluteus medius. Level of evidence Level IV.

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