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Semin Musculoskelet Radiol 2013; 17(03): 295-305
DOI: 10.1055/s-0033-1348096
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Imaging Lesions of the Lateral Hip

Judong Pan
1   Radiological Associates Medical Group, San Jose, California
,
Miriam A. Bredella
2   Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
› Author Affiliations
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Publication History

Publication Date:
20 June 2013 (online)

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Abstract

The lateral aspect of the hip is composed of a complex array of osseous and soft tissue structures. Both common and uncommon clinical entities are encountered in the lateral hip. This article briefly introduces fundamental imaging anatomy and the functional roles of different osseous and soft tissue structures in the lateral aspect of the hip, followed by a discussion of relevant imaging findings of lateral hip pathology. Greater trochanteric pain syndrome is frequently encountered in patients with lateral hip pain and encompasses a spectrum of soft tissue abnormalities including trochanteric and subgluteal bursitis, and tendinopathy or tears of the gluteal tendons. In addition, different types of injuries to the gluteal myotendinous unit and injuries to the indirect head of the rectus femoris, proximal iliotibial band, and the lateral joint capsular ligaments can present with lateral hip pain. Some of the less common soft tissue abnormalities of the lateral hip include Morel-Lavallée lesion and meralgia paresthetica.

Keywords

lateral hip - greater trochanteric pain syndrome - proximal iliotibial band - Morel-Lavallée lesion - meralgia paresthetica
 

  • References

  • 1 Blankenbaker DG, Ullrick SR, Davis KW, De Smet AA, Haaland B, Fine JP. Correlation of MRI findings with clinical findings of trochanteric pain syndrome. Skeletal Radiol 2008; 37 (10) 903-909
    CrossrefPubMedGoogle Scholar
  • 2 Cvitanic O, Henzie G, Skezas N, Lyons J, Minter J. MRI diagnosis of tears of the hip abductor tendons (gluteus medius and gluteus minimus). AJR Am J Roentgenol 2004; 182 (1) 137-143
    CrossrefPubMedGoogle Scholar
  • 3 Kong A, Van der Vliet A, Zadow S. MRI and US of gluteal tendinopathy in greater trochanteric pain syndrome. Eur Radiol 2007; 17 (7) 1772-1783
    CrossrefPubMedGoogle Scholar
  • 4 Pfirrmann CW, Chung CB, Theumann NH, Trudell DJ, Resnick D. Greater trochanter of the hip: attachment of the abductor mechanism and a complex of three bursae—MR imaging and MR bursography in cadavers and MR imaging in asymptomatic volunteers. Radiology 2001; 221 (2) 469-477
    CrossrefPubMedGoogle Scholar
  • 5 Blankenbaker DG, Tuite MJ. The painful hip: new concepts. Skeletal Radiol 2006; 35 (6) 352-370
    CrossrefPubMedGoogle Scholar
  • 6 Bencardino JT, Kassarjian A, Palmer WE. Magnetic resonance imaging of the hip: sports-related injuries. Top Magn Reson Imaging 2003; 14 (2) 145-160
    CrossrefPubMedGoogle Scholar
  • 7 Manaster BJ. From the RSNA Refresher Courses. Radiological Society of North America. Adult chronic hip pain: radiographic evaluation. Radiographics 2000; 20 ( Spec No) S3-S25
    PubMedGoogle Scholar
  • 8 Palmer WE, Kuong SJ, Elmadbouh HM. MR imaging of myotendinous strain. AJR Am J Roentgenol 1999; 173 (3) 703-709
    CrossrefPubMedGoogle Scholar
  • 9 Steinbach LS, Fleckenstein JL, Mink JH. Magnetic resonance imaging of muscle injuries. Orthopedics 1994; 17 (11) 991-999
    PubMedGoogle Scholar
  • 10 Gomez P, Morcuende J. High-grade sarcomas mimicking traumatic intramuscular hematomas: a report of three cases. Iowa Orthop J 2004; 24: 106-110
    PubMedGoogle Scholar
  • 11 Lee YS, Kwon ST, Kim JO, Choi ES. Serial MR imaging of intramuscular hematoma: experimental study in a rat model with the pathologic correlation. Korean J Radiol 2011; 12 (1) 66-77
    CrossrefPubMedGoogle Scholar
  • 12 Kneeland JB. MR imaging of sports injuries of the hip. Magn Reson Imaging Clin N Am 1999; 7 (1) 105-115 , viii
    PubMedGoogle Scholar
  • 13 Gyftopoulos S, Rosenberg ZS, Schweitzer ME, Bordalo-Rodrigues M. Normal anatomy and strains of the deep musculotendinous junction of the proximal rectus femoris: MRI features. AJR Am J Roentgenol 2008; 190 (3) W182-W186
    CrossrefPubMedGoogle Scholar
  • 14 Ouellette H, Thomas BJ, Nelson E, Torriani M. MR imaging of rectus femoris origin injuries. Skeletal Radiol 2006; 35 (9) 665-672
    CrossrefPubMedGoogle Scholar
  • 15 Sher I, Umans H, Downie SA, Tobin K, Arora R, Olson TR. Proximal iliotibial band syndrome: what is it and where is it?. Skeletal Radiol 2011; 40 (12) 1553-1556
    CrossrefPubMedGoogle Scholar
  • 16 Ito H, Song Y, Lindsey DP, Safran MR, Giori NJ. The proximal hip joint capsule and the zona orbicularis contribute to hip joint stability in distraction. J Orthop Res 2009; 27 (8) 989-995
    CrossrefPubMedGoogle Scholar
  • 17 Wagner FV, Negrão JR, Campos J , et al. Capsular ligaments of the hip: anatomic, histologic, and positional study in cadaveric specimens with MR arthrography. Radiology 2012; 263 (1) 189-198
    CrossrefPubMedGoogle Scholar
  • 18 Myers CA, Register BC, Lertwanich P , et al. Role of the acetabular labrum and the iliofemoral ligament in hip stability: an in vitro biplane fluoroscopy study. Am J Sports Med 2011; 39 (Suppl): 85S-91S
    CrossrefPubMedGoogle Scholar
  • 19 Mellado JM, Pérez del Palomar L, Díaz L, Ramos A, Saurí A. Long-standing Morel-Lavallée lesions of the trochanteric region and proximal thigh: MRI features in five patients. AJR Am J Roentgenol 2004; 182 (5) 1289-1294
    CrossrefPubMedGoogle Scholar
  • 20 Mukherjee K, Perrin SM, Hughes PM. Morel-Lavallee lesion in an adolescent with ultrasound and MRI correlation. Skeletal Radiol 2007; 36 (Suppl. 01) S43-S45
    CrossrefPubMedGoogle Scholar
  • 21 Mellado JM, Bencardino JT. Morel-Lavallée lesion: review with emphasis on MR imaging. Magn Reson Imaging Clin N Am 2005; 13 (4) 775-782
    CrossrefPubMedGoogle Scholar
  • 22 Grothaus MC, Holt M, Mekhail AO, Ebraheim NA, Yeasting RA. Lateral femoral cutaneous nerve: an anatomic study. Clin Orthop Relat Res 2005; (437) 164-168
    PubMedGoogle Scholar
  • 23 Ivins GK. Meralgia paresthetica, the elusive diagnosis: clinical experience with 14 adult patients. Ann Surg 2000; 232 (2) 281-286
    CrossrefPubMedGoogle Scholar
  • 24 Petchprapa CN, Rosenberg ZS, Sconfienza LM, Cavalcanti CF, Vieira RL, Zember JS. MR imaging of entrapment neuropathies of the lower extremity. Part 1. The pelvis and hip. Radiographics 2010; 30 (4) 983-1000
    CrossrefPubMedGoogle Scholar