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    • #15598

      Hi Steve,

      I got this patient coming in saying she had lateral hip pain with difficulty walking up the stairs. I did find some tendinopathic gluteal tendons and bursal thickening of Troch bursa.

      However, as I scan through the posterior hip where she did not indicate any pain, I found a collection with stranding in it. Patient denied trauma or any recent fall.

      The clips were taken as I told the patient to flex the knee and do a tick tock manoeuvre (external-internal rotation at the knee to activate the deep lateral rotators) and I can see the collection changes in shape, so I thought it was a haematoma rather than a deep bursa.

      The radiologist thinks there is a gemellus tear. But I am not quite sure how a lateral rotator tear looks like other than seeing the secondary signs (the haematoma). Do you have any examples of these tears?

      Best regards,

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    • #15639
      Stephen Bird

      Hi Linh,

      Nice pictures,

      I am not worried about this appearance,

      I think the hypo echoic area is simply some fat,

      Nothing to worry about and nothing pathological,

      Tears of the deep lateral rotators in my opinion are rare and without a history of trauma in a patient of this demographic it makes no sense,

      I think it is fat in the potential space adjacent to the sciatic nerve.


      The G-min and G-med tendinosis and associated bursopathy is a likely cause for the symptoms.


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