An examination of imaging findings in patients with clinically diagnosed gluteal tendinopathy

Key points

1. 01This was a secondary analysis of imaging data from participants in a randomised clinical trial who already had a clinical diagnosis of gluteal tendinopathy.
2. 02MRI and ultrasound showed a spectrum of gluteal tendon and bursal pathology rather than a single uniform finding.
3. 03In some patients the severity of changes on imaging did not line up with the severity of their symptoms.
4. 04The authors conclude imaging complements the clinical diagnosis but does not fully explain symptom severity.

How it was conducted

Design

Secondary analysis of the imaging cohort from a randomised clinical trial

Participants

Trial participants with a clinical diagnosis of gluteal tendinopathy

Imaging modality

MRI and ultrasound

Aim

Describe the MRI and ultrasound findings in this clinically diagnosed group

What they found

• MRI and ultrasound showed a spectrum of gluteal tendon and bursal pathology across participants.
• There was discordance between imaging severity and symptom severity in some patients.

Limitations

• This was a secondary analysis of an existing trial cohort, not a study designed primarily to relate imaging to symptoms.
• The reported findings are descriptive, with no effect sizes, diagnostic accuracy figures, or comparison group reported in the available text.
• Participants were already clinically diagnosed, so the findings may not apply to people with hip pain of uncertain cause.

Why it matters

For patients

A scan showing tendon or bursal changes does not by itself tell you how severe your gluteal tendon problem is, so treatment should be guided by your symptoms and clinical assessment, not the scan alone.

For clinicians

Use imaging to complement, not replace, the clinical diagnosis of gluteal tendinopathy, and be cautious about reading symptom severity directly off imaging severity.

For readers

In clinically diagnosed gluteal tendinopathy, imaging shows varied tendon and bursal pathology that does not reliably track with how bad symptoms are.