Prevalence of Gluteus Medius Pathology on MRI in Patients Undergoing Hip Arthroscopy for Femoroacetabular Impingement: Asymptomatic Tears Are Rare, Whereas Tendinosis Is Common

Prevalence of Gluteus Medius Pathology on MRI in Patients Undergoing Hip Arthroscopy for Femoroacetabular Impingement: Asymptomatic Tears Are Rare, Whereas Tendinosis Is Common

Authors: Meghpara MB, Bheem R, Shah S, Shapira J, Maldonado DR, Rosinsky PJ, Lall AC, Domb BG

DOI: 10.1177/0363546520952766

Background:

Gluteus medius pathology is frequently observed in femoroacetabular impingement (FAI) patients, but the frequency of asymptomatic pathology is unclear.

Methods:

MRI scans from 2,851 hips in 2,452 patients undergoing hip arthroscopy were reviewed for gluteus medius tendinosis and tears, with correlation to symptoms such as tenderness and weakness.

Key Findings:

• 30.6% of hips had gluteus medius pathology; 16% were asymptomatic.
• Asymptomatic pathology predominantly involved tendinosis rather than tears.
• Partial-thickness tears were seen more in older patients; full-thickness tears were always symptomatic.

Conclusions:

Gluteus medius tendinosis is common and frequently asymptomatic in FAI patients, while full-thickness tears almost always present with symptoms. Clinical correlation remains critical for management decisions.

What Does This Mean for Providers?

Interpret gluteus medius MRI findings in the clinical context. Tendinosis alone, especially if asymptomatic, may not require surgical intervention. Be vigilant in evaluating symptoms for patients with tears, particularly full-thickness tears, which are likely clinically significant.