Deep lateral rotator tear

[Linh]

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,
Linh

Attachments:

You must be logged in to view attached files.

[Linh]

.

[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.

Normal.

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

Steve.

[Author]

Posts