Sean Iain Docking1, Jill Cook2, Stephanie Chen3, Jennie Scarvell4, Wes Cormick5, Paul Smith6, Angela Fearon7. 1. La Trobe Sports and Exercise Medicine Research Centre, La Trobe University, Bundoora, 3086, Australia. Electronic address: s.docking@latrobe.edu.au. 2. La Trobe Sports and Exercise Medicine Research Centre, La Trobe University, Bundoora, 3086, Australia. 3. Canberra Imaging Group, Canberra 2600, Australia. 4. Discipline of Physiotherapy, Faculty of Health, University of Canberra, Canberra, 2617, Australia. 5. Canberra Specialist Ultrasound, Canberra, 2617, Australia. 6. Division of Surgery, The Canberra Hospital, Canberra, 2605, Australia; College of Medicine and Health Sciences, Australian National University, Canberra, 0200, Australia. 7. Discipline of Physiotherapy, Faculty of Health, University of Canberra, Canberra, 2617, Australia; Research Institute for Sport and Exercise, University of Canberra, 2617, Australia.
Abstract
BACKGROUND: It has been suggested that imaging findings play a role in directing treatment for Greater Trochanteric Pain Syndrome. Structural diagnoses associated with Greater Trochanter Pain Syndrome include gluteal tendinosis, and partial- or full-thickness gluteal tendon tears. However, few studies have compared imaging to confirmed tendon pathology observed during surgery. OBJECTIVE: To investigate the ability of magnetic resonance and ultrasound imaging to identify the presence of a pathological gluteus medius tendon in comparison to surgical and histological findings. STUDY DESIGN: Cross-sectional study. METHODS: 26 participants undergoing gluteal tendon reconstruction surgery or hip arthroplasty were included. Prior to surgery, participants underwent both magnetic resonance (MR) (n = 23) and ultrasound (US) (n = 25) imaging. A radiologist (MR) and nuclear physicians (US) classified the gluteus medius tendon as normal, tendinosis (no tear), partial-thickness tear, or full-thickness tear. RESULTS: Ultrasound identified 17 out of the 19 pathological gluteus medius tendons correctly. However, 5 of the 6 normal tendons were incorrectly identified as exhibiting pathology on ultrasound. Magnetic resonance rated 11 out of 17 pathological tendons as abnormal, with 4 out of 6 normal tendons identified correctly. Both imaging modalities were poor at identifying and differentiating between tendinosis and partial-thickness tears. CONCLUSION: Both imaging modalities showed a reasonable ability to identify tendon pathology. While limited by sample size, these early findings suggest that both imaging modalities may be limited in identifying specific pathoanatomical diagnoses, such as partial-thickness tears. These limitations may misdirect treatment.
BACKGROUND: It has been suggested that imaging findings play a role in directing treatment for Greater Trochanteric Pain Syndrome. Structural diagnoses associated with Greater Trochanter Pain Syndrome include gluteal tendinosis, and partial- or full-thickness gluteal tendon tears. However, few studies have compared imaging to confirmed tendon pathology observed during surgery. OBJECTIVE: To investigate the ability of magnetic resonance and ultrasound imaging to identify the presence of a pathological gluteus medius tendon in comparison to surgical and histological findings. STUDY DESIGN: Cross-sectional study. METHODS: 26 participants undergoing gluteal tendon reconstruction surgery or hip arthroplasty were included. Prior to surgery, participants underwent both magnetic resonance (MR) (n = 23) and ultrasound (US) (n = 25) imaging. A radiologist (MR) and nuclear physicians (US) classified the gluteus medius tendon as normal, tendinosis (no tear), partial-thickness tear, or full-thickness tear. RESULTS: Ultrasound identified 17 out of the 19 pathological gluteus medius tendons correctly. However, 5 of the 6 normal tendons were incorrectly identified as exhibiting pathology on ultrasound. Magnetic resonance rated 11 out of 17 pathological tendons as abnormal, with 4 out of 6 normal tendons identified correctly. Both imaging modalities were poor at identifying and differentiating between tendinosis and partial-thickness tears. CONCLUSION: Both imaging modalities showed a reasonable ability to identify tendon pathology. While limited by sample size, these early findings suggest that both imaging modalities may be limited in identifying specific pathoanatomical diagnoses, such as partial-thickness tears. These limitations may misdirect treatment.
Authors: Ajay C Lall; Garrett R Schwarzman; Muriel R Battaglia; Sarah L Chen; David R Maldonado; Benjamin G Domb Journal: Arthrosc Tech Date: 2019-08-01
Authors: Robert B Browning; Ian M Clapp; Thomas D Alter; Benedict U Nwachukwu; Theodore Wolfson; Sunikom Suppauksorn; Shane J Nho Journal: Arthrosc Sports Med Rehabil Date: 2021-07-08
Authors: Eleuterio A Sánchez Romero; Joel Pollet; Sebastián Martín Pérez; José Luis Alonso Pérez; Alberto Carlos Muñoz Fernández; Paolo Pedersini; Carlos Barragán Carballar; Jorge Hugo Villafañe Journal: Medicina (Kaunas) Date: 2020-07-28 Impact factor: 2.430