Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada.
Joint Department of Medical Imaging, Mount Sinai Hospital, 600 University Ave, Rm 562-A, Toronto, Ontario, M5G 1X5, Canada.
Skeletal Radiol. 2021 Oct;50(10):2013-2021. doi: 10.1007/s00256-021-03745-4. Epub 2021 Mar 29.
To highlight the spectrum of pathology and patterns of gluteus minimus tendon tearing observed on MR imaging of the hip.
Retrospective review of consecutive hip MRI exams with findings of gluteus minimus tendon (GMin) pathology. A total of 194 exams in 178 patients (148 female, mean age 61) were reviewed. MRI exams are assessed for GMin: tendinopathy, partial, or complete tendon tears. GMin muscular fatty atrophy, enthesopathic cortical irregularities of the greater trochanter (GT), and peri-trochanteric edema or bursal fluid collections were assessed in all cases. In all cases of complete GMin tendon tearing, position and relationship of GMin tendon were assessed relative to its normal insertion site and adjacent soft tissues.
Clinical indications for MR imaging included hip pain (n = 151), and weakness or altered gait (n = 13). Insertional GMin tendinopathy was seen in 72, partial tearing in 81, and complete tendon tearing in 40 cases. Complete tendon tearing without proximal retraction was observed in 38/40 cases with soft tissue continuity visualized between distal tendon fibers and the proximal vastus lateralis muscle. Peri-trochanteric bursal fluid (n = 61), osseous irregularities of the GT (n = 118), and fatty atrophy GMin (n = 102) were statistically associated with partial or complete GMin tendon tearing (p < 0.001).
The spectrum of GMin tendon pathology observed on MR imaging ranges from tendinopathy to complete tears. The majority of complete distal GMin tendon tears from the greater trochanter show continuity of distal tendon fibers with the proximal vastus lateralis, distally tethering and limiting proximal tendon retraction.
强调臀小肌肌腱撕裂在髋关节磁共振成像（MRI）上的病理表现和模式。
回顾性分析连续髋关节 MRI 检查结果，发现臀小肌肌腱（GMin）病变。共对 178 例患者的 194 次 MRI 检查（148 例女性，平均年龄 61 岁）进行了回顾性分析。MRI 检查评估 GMin：肌腱病、部分或完全肌腱撕裂。所有病例均评估臀小肌肌脂肪萎缩、大转子（GT）附着处皮质不规则和转子间周围水肿或滑囊积液。在所有完全 GMin 肌腱撕裂的病例中，评估 GMin 肌腱相对于其正常附着点和相邻软组织的位置和关系。
MR 成像的临床指征包括髋痛（n=151）和无力或步态改变（n=13）。插入性 GMin 肌腱病 72 例，部分撕裂 81 例，完全撕裂 40 例。在 40 例无近端回缩的完全肌腱撕裂中，在远端肌腱纤维和近端股外侧肌之间可见软组织连续性。转子间滑囊积液（n=61）、GT 骨不规则（n=118）和臀小肌脂肪萎缩（n=102）与部分或完全 GMin 肌腱撕裂有统计学相关性（p<0.001）。
MR 成像上观察到的 GMin 肌腱病变范围从肌腱病到完全撕裂。大多数从大转子开始的远端 GMin 完全性肌腱撕裂显示远端肌腱纤维与近端股外侧肌之间的连续性，远端束缚并限制近端肌腱回缩。
