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Hip Abductor and Rotator Injury
MK Jesse, MD; Adam C. Zoga, MD; Kirkland W. Davis, MD, FACR
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KEY FACTS

  • Terminology

    • Imaging

      • Pathology

        • Clinical Issues

          • Diagnostic Checklist

            TERMINOLOGY

            • Synonyms

              • Rotator cuff of hip; hip rotators
            • Definitions

              • Injury anywhere along myotenoosseous axis of hip rotator(s)
                • Gluteus maximus, medius, and minimus
                • Deep external rotators
                • Tensor fascia lata/iliotibial band

            IMAGING

            • General Features

              • Radiographic Findings

                • CT Findings

                  • MR Findings

                    • Ultrasonographic Findings

                      • Imaging Recommendations

                        • Nuclear Medicine Findings

                          DIFFERENTIAL DIAGNOSIS

                            PATHOLOGY

                            • Staging, Grading, & Classification

                              • Gross Pathologic & Surgical Features

                                • Muscle Group Function

                                  CLINICAL ISSUES

                                  • Presentation

                                    • Demographics

                                      • Natural History & Prognosis

                                        • Treatment

                                          DIAGNOSTIC CHECKLIST

                                          • Consider

                                            • Image Interpretation Pearls

                                              • Reporting Tips

                                                Selected References

                                                1. Oehler N et al: Hip abductor tendon pathology visualized by 1.5 versus 3. 0 Tesla MRIs. Arch Orthop Trauma Surg. 140(2):145-53, 2020
                                                2. Hartigan DE et al: Radiographic risk factors and signs of abductor tears in the hip. Arthroscopy. 34(8):2389-97, 2018
                                                3. Klontzas ME et al: Hydroxyapatite deposition disease around the hip: outcomes of CT-guided treatment. Diagn Interv Radiol. 22(5):466-70, 2016
                                                4. Ryan J et al: Risk factors for groin/hip injuries in field-based sports: a systematic review. Br J Sports Med. 48(14):1089-96, 2014
                                                5. Blankenbaker DG et al: Non-femoroacetabular impingement. Semin Musculoskelet Radiol. 17(3):279-85, 2013
                                                6. Jesse MK et al: Normal anatomy and imaging of the hip: emphasis on impingement assessment. Semin Musculoskelet Radiol. 17(3):229-47, 2013
                                                7. Pan J et al: Imaging lesions of the lateral hip. Semin Musculoskelet Radiol. 17(3):295-305, 2013
                                                8. Labrosse JM et al: Effectiveness of ultrasound-guided corticosteroid injection for the treatment of gluteus medius tendinopathy. AJR Am J Roentgenol. 194(1):202-6, 2010
                                                9. Housner JA et al: Sonographically guided percutaneous needle tenotomy for the treatment of chronic tendinosis. J Ultrasound Med. 28(9):1187-92, 2009
                                                10. Kalhor M et al: Capsular and pericapsular contributions to acetabular and femoral head perfusion. J Bone Joint Surg Am. 91(2):409-18, 2009
                                                11. Rasch A et al: Persisting muscle atrophy two years after replacement of the hip. J Bone Joint Surg Br. 91(5):583-8, 2009
                                                12. Sanders TG et al: Avulsion injuries of the pelvis. Semin Musculoskelet Radiol. 12(1):42-53, 2008
                                                13. Kong A et al: MRI and US of gluteal tendinopathy in greater trochanteric pain syndrome. Eur Radiol. 17(7):1772-83, 2007
                                                14. Connell DA et al: Sonographic evaluation of gluteus medius and minimus tendinopathy. Eur Radiol. 13(6):1339-47, 2003
                                                15. Chin KR et al: Reattachment of the migrated ununited greater trochanter after revision hip arthroplasty: the abductor slide technique. A review of four cases. J Bone Joint Surg Am. 82(3):401-8, 2000
                                                Related Anatomy
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                                                Related Differential Diagnoses
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                                                References
                                                Tables

                                                Tables

                                                KEY FACTS

                                                • Terminology

                                                  • Imaging

                                                    • Pathology

                                                      • Clinical Issues

                                                        • Diagnostic Checklist

                                                          TERMINOLOGY

                                                          • Synonyms

                                                            • Rotator cuff of hip; hip rotators
                                                          • Definitions

                                                            • Injury anywhere along myotenoosseous axis of hip rotator(s)
                                                              • Gluteus maximus, medius, and minimus
                                                              • Deep external rotators
                                                              • Tensor fascia lata/iliotibial band

                                                          IMAGING

                                                          • General Features

                                                            • Radiographic Findings

                                                              • CT Findings

                                                                • MR Findings

                                                                  • Ultrasonographic Findings

                                                                    • Imaging Recommendations

                                                                      • Nuclear Medicine Findings

                                                                        DIFFERENTIAL DIAGNOSIS

                                                                          PATHOLOGY

                                                                          • Staging, Grading, & Classification

                                                                            • Gross Pathologic & Surgical Features

                                                                              • Muscle Group Function

                                                                                CLINICAL ISSUES

                                                                                • Presentation

                                                                                  • Demographics

                                                                                    • Natural History & Prognosis

                                                                                      • Treatment

                                                                                        DIAGNOSTIC CHECKLIST

                                                                                        • Consider

                                                                                          • Image Interpretation Pearls

                                                                                            • Reporting Tips

                                                                                              Selected References

                                                                                              1. Oehler N et al: Hip abductor tendon pathology visualized by 1.5 versus 3. 0 Tesla MRIs. Arch Orthop Trauma Surg. 140(2):145-53, 2020
                                                                                              2. Hartigan DE et al: Radiographic risk factors and signs of abductor tears in the hip. Arthroscopy. 34(8):2389-97, 2018
                                                                                              3. Klontzas ME et al: Hydroxyapatite deposition disease around the hip: outcomes of CT-guided treatment. Diagn Interv Radiol. 22(5):466-70, 2016
                                                                                              4. Ryan J et al: Risk factors for groin/hip injuries in field-based sports: a systematic review. Br J Sports Med. 48(14):1089-96, 2014
                                                                                              5. Blankenbaker DG et al: Non-femoroacetabular impingement. Semin Musculoskelet Radiol. 17(3):279-85, 2013
                                                                                              6. Jesse MK et al: Normal anatomy and imaging of the hip: emphasis on impingement assessment. Semin Musculoskelet Radiol. 17(3):229-47, 2013
                                                                                              7. Pan J et al: Imaging lesions of the lateral hip. Semin Musculoskelet Radiol. 17(3):295-305, 2013
                                                                                              8. Labrosse JM et al: Effectiveness of ultrasound-guided corticosteroid injection for the treatment of gluteus medius tendinopathy. AJR Am J Roentgenol. 194(1):202-6, 2010
                                                                                              9. Housner JA et al: Sonographically guided percutaneous needle tenotomy for the treatment of chronic tendinosis. J Ultrasound Med. 28(9):1187-92, 2009
                                                                                              10. Kalhor M et al: Capsular and pericapsular contributions to acetabular and femoral head perfusion. J Bone Joint Surg Am. 91(2):409-18, 2009
                                                                                              11. Rasch A et al: Persisting muscle atrophy two years after replacement of the hip. J Bone Joint Surg Br. 91(5):583-8, 2009
                                                                                              12. Sanders TG et al: Avulsion injuries of the pelvis. Semin Musculoskelet Radiol. 12(1):42-53, 2008
                                                                                              13. Kong A et al: MRI and US of gluteal tendinopathy in greater trochanteric pain syndrome. Eur Radiol. 17(7):1772-83, 2007
                                                                                              14. Connell DA et al: Sonographic evaluation of gluteus medius and minimus tendinopathy. Eur Radiol. 13(6):1339-47, 2003
                                                                                              15. Chin KR et al: Reattachment of the migrated ununited greater trochanter after revision hip arthroplasty: the abductor slide technique. A review of four cases. J Bone Joint Surg Am. 82(3):401-8, 2000