Weekly Case

Title : Case 615

Age / Sex : 35 / F


Chief complaint : palpable lesion in left proximal thigh

What is your impression?

Two weeks later, you can see the final diagonosis with a brief discussion of this case (Please submit only one answer).

Courtesy : Seok Han, Inje University Haeundae Paik Hospital



Discussion


Answer:


Calcific tendinitis of gluteus maximus tendon


 


Findings:


X-ray: a relatively homogeneous and well-defined calcification deposition in posterolateral aspect of left upper thigh level


MRI: heterogenous signal intensity lesion at gluteal tuberosity of left femur with contrast enhancement in adjacent soft tissue


 


Differential Diagnosis:


myositis ossificans, periosteal chondral tumor, osteogenic or synovial sarcoma


 


Discussion:


Calcific tendinitis is a common disorder of the supraspinatus tendon, but less frequently, it may also involve the tendons of the gluteus maximus. Anatomically, there are two components of the tendon of the gluteus maximus muscle. The more proximal and major portion of the muscle fibers ends in a tendinous insertion on the iliotibial band of the tensor fascia lata dorsal and distal to the greater trochanter on the dorsal aspect of the femur. The gluteal tuberosity is a short ridge of bone representing the proximal and lateral extension of the linea aspera.


Clinically, most patients with acute gluteus maximus tendinitis present with severe pain in the hip and upper thigh posteriorly. On physical examination focal tenderness is elicited over the gluteal tubercle.


 


References:


Skeletal Radiol. 1983;9(3):198-200.


Clin Radiol. 1998 Apr;53(4):296-301.



Correct Answer
Total applicants 30 Correct answers 24
Name Institution
김기욱 국군대전병원, 전문의
윤유성 순천향대 부천병원, 전문의
남태훈 국군서울지구병원, 전문의
조영민 전문의
조은경 새움병원, 전문의
손상욱 군의관, 전문의
권환웅 경상대학교병원, 전공의
김지현 전문의
이재형 분당 서울대학교병원, 전문의
김동수 전공의
안유라 전공의
김창현 전문의
정보미 전문의
이혜란 전문의
장성원 중앙보훈병원, 전공의
최형인 국군의무학교, 전문의
강지희 서울대학교병원, 전문의
고아라 전공의
김보람 분당서울대학교병원, 전문의
최희석 전병원, 전문의
김지은 서울대학교병원, 전문의
최희영 동수원병원, 전문의
김형민 전문의
이지현 삼성서울병원, 전문의


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