The Modified Resisted Internal Rotation Test for Detection of Gluteal Tendon Tears
Authors: Walker-Santiago R, Ortiz-Declet V, Maldonado DR, Wojnowski NM, Domb BG
DOI: 10.1016/j.eats.2018.11.006
Background:
- Greater trochanteric pain syndrome (GTPS) is commonly treated as bursitis, but gluteal tendon pathology is often overlooked.
- Delayed diagnosis of gluteal tendon tears can lead to chronic disability and poorer outcomes.
Methods & Findings:
- The modified resisted internal rotation test was developed as a more sensitive physical exam maneuver for detecting gluteal tendon tears in patients with GTPS-like symptoms.
- The maneuver combines resisted hip internal rotation in slight flexion and abduction, isolating gluteus medius and minimus function.
- It showed high diagnostic utility and can help distinguish gluteal tendinopathy from trochanteric bursitis.
What Does This Mean for Providers?
- Incorporate the modified resisted internal rotation test into physical exams for patients with lateral hip pain, especially those unresponsive to conservative GTPS treatments.
- Early detection of gluteal tendon tears allows for timely referral for imaging and potential surgical intervention.
- Reduces misdiagnosis and delays in managing a potentially reparable cause of chronic hip pain.