Session Title: AA 2022 Posters - Musculoskeletal and Sports Medicine
Session Time: None. Available on demand.
Disclosures: Bryan Le, MD: No financial relationships or conflicts of interest
Case Diagnosis: This was a 51-year-old female runner who presented with 1 year of right lateral hip pain, found to have gluteus maximus calcific tendinopathy.
Case Description or Program Description: She described the pain as an aching, 7/10 pain that referred anteriorly of thigh and superiorly to the low back. Her pain worsened with running and lying on the affected side. The pain was alleviated with rest. She was prescribed 8 weeks of PT without significant improvement. On exam, she had palpable, tender nodules 5 cm inferior and posterior to greater trochanter. She had 3/5 strength on hip extension and hip abduction, limited by pain.
Setting: Tertiary Outpatient Clinic
Assessment/Results: An x-ray of the hip showed calcification to the proximal lateral femur, distal to the greater trochanter. On ultrasound of the lateral hip, the calcification was found within the gluteus maximus tendon. The hip MRI did not show any evidence of tear. The patient received a percutaneous needle tenotomy at the tendon insertion at the right gluteus maximus. At her follow up visit 4 months later, she had 80% resolution in her symptoms. She was able to start resumption of walking and running.
Discussion (relevance): The etiology of calcific tendinopathy remains unknown. It is commonly found on the supraspinatus tendon, and reports of this presenting in the hip are less common. Other treatment modalities include physical therapy, corticosteroid injection, barbotage and endoscopic surgery. While there is literature supporting percutaneous tenotomy for calcific tendinopathy for the gluteus medius and minimus, there is limited study of its use for the gluteus maximus.
Conclusions: This case highlights percutaneous tenotomy as a potential treatment modality for a rare location in calcific tendinopathy.
Level of Evidence: Level V
To cite this abstract in AMA style:Le B, Makovitch SA. Ultrasound Guided Percutaneous Tenotomy for Gluteus Maximus Calcific Tendinopathy: A Case Report [abstract]. PM R. 2022; 14(S1)(suppl 1). https://pmrjabstracts.org/abstract/ultrasound-guided-percutaneous-tenotomy-for-gluteus-maximus-calcific-tendinopathy-a-case-report/. Accessed December 3, 2023.
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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/ultrasound-guided-percutaneous-tenotomy-for-gluteus-maximus-calcific-tendinopathy-a-case-report/