Atul Taneja recommended an excellent relevant article from 2014: I’ve shared the reference and first images below
On Tue, Jun 25, 2024 at 2:48 PM hilary umans <hilary.umans> wrote:
61F 1-2 months posterior upper butt pain
Orthopedic hip surgeon suspected gluteus tendonosis or tear
I had thought that the axial image might be posterior band G Medius tendinosis, but the Cor images make it clear that this is the insertion of hip external rotators (I suspect pyriformis +/- superior gemellus) with normal G Medius tendon
The red arrow indicates the peritendinous edema of the external rotators
More medially the white arrows point to a delaminated tear of the proximal hamstring tendon complex…which is peeled off the ischial tuberosity along with the insertion of the sacrotuberous ligament
The delaminated hamstrings are displaced medial to the bare tuberosity
It’s difficult to appreciate in fatsat (we don’t have non fat sat Ax images) but there is severe narrowing of the ischiofemoral space….I believe there is fatty atrophy of the quadratus femoris muscle, which should be there
Almost bone on bone narrowing of the ischiofemoral space!
Red: external rotators
White: hamstrings / sacrotuberous ligament
I found this simplistic diagram from a yoga site
