Gluteal tendinopathy

Last revised by Joshua Yap on 2 Feb 2024

Gluteal tendinopathy is a common cause of lateral hip pain. Ultrasound and MRI play an important role in diagnosis.

Gluteal tendinopathy commonly presents around the 4th to 6th decade of life. Females are more affected than males.

It presents as chronic lateral hip pain. The pain occurs while walking, lying on the side of the hip, or when performing weight-bearing tasks of the hip 1. There is tenderness over the greater trochanteric region on palpation.

Ultrasound has a high sensitivity 79-100% and high positive predictive value 95-100% in diagnosing gluteal tendon tears 2.

Gluteal tendinopathy can be divided into 4 grades 3:

  • grade 1: bursitis with no or minimal signal change within the tendon

  • grade 2: tendinopathy with increased T1 signal but normal T2 signal within the tendon

  • grade 3: partial thickness tear with increased T2 signal within the tendon

  • grade 4: full thickness tear with tendon discontinuity

Gluteal tendinopathy is usually managed conservatively. This includes topical or systemic analgesics, physiotherapy, corticosteroid injections or shockwave therapy. Surgical options are usually reserved for refractory cases 3.

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