Korean J Sports Med.  2011 Dec;29(2):89-92. 10.5763/kjsm.2011.29.2.89.

The Effect of Conservative Treatment for the Calcific Tendinitis on Gluteus Medius Tendon

• Yim SJ
• Jang MS
• Lee SH
• Lee SH
• Kang HK

• KMID: 1987187
• DOI: http://doi.org/10.5763/kjsm.2011.29.2.89

Abstract

Calcific tendinitis on gluteus medius tendon of the amateur athletes were reviewed, and a study on the therapeutic effect of conservative treatment methods. From January 2003 to December 2010, among the patients who had been treated with calcific tendinitis on gluteus medius tendon, there were nine patients available to monitor more than a year as outpatients. ten cases were observed from them and were retrospectively analyzed and magnetic resonance examinations were performed in every case. All of the ten cases were initially treated with non-steroid anti-inflammatory oral doses. If a non-steroid anti-inflammatory treatment could not relieve pain or caused an aggravation of a condition, a local steroid injection was enforced. There were responses to non-steroid antiinflammatory oral doses of therapeutic methods in four cases and the time required for the symptoms to be improved was approximately 3 weeks (range: 1-3 weeks). In the remainder of six cases, conditions got worsened or did not improve even after 3 weeks. In these cases, the condition was altered for better in 3 days (range: 1-3 days) by using local steroid injections. There was no recurrence in all cases. The amateur athlete with a severe pain around his or her hip joint should be questioned with calcific tendinitis on gluteus medius tendon and differential diagnosis of hip around diseases. After calcific tendinitis was diagnosed, initial treatment was considered conserevative treatment. Although it is invasive, the initial treatment with a local steroid injection is considered to be helpful in treating amateur athletes with calcific tendinitis.

Keyword

Gluteus medius tendon; Calcific tendinitis; Local steroid injection

MeSH Terms

Athletes
Diagnosis, Differential
Hip
Hip Joint
Humans
Magnetic Resonance Spectroscopy
Organothiophosphorus Compounds
Outpatients
Recurrence
Retrospective Studies
Tendinopathy
Tendons
Organothiophosphorus Compounds

Figure

• 

  Fig. 1. A 30-year-old male with the right hip pain and gait disturbance. Plain anteroposterior radiograph shows amor-phous calcification (arrow) around the insertion site of right gluteus medius muscle.

• 

  Fig. 2. (A) T1-weighted axial image shows the low singnal (arrow) around the insertion site of right gluteus medius muscle.(B) T2-weighted axial image shows the central low enhancement with peripheral high enhancement area (arrow) in the insertion site of right gluteus medius muscle.

Reference

References

1. Kandemir U, Bharam S, Philippon MJ, Fu FH. Endoscopic treatment of calcific tendinitis of gluteus medius and minimus. Arthroscopy. 2003; 19:E4.

2. Lee HS, Lee YH, Sung NK, et al. Sonographic findings of calcific tendinitis around the hip. J Korean Soc Ultrasound Med. 2005; 24:139–44.

3. Lee SW, Ahn J, Cho MR. Calcific tendinitis of the gluteus medius tendon. J Korean Hip Soc. 2009; 21:351–5.

4. Oh KJ, Yoon JR, Shin DS, Yang JH. Extracorporeal shock wave therapy for calcific tendinitis at unusual sites around the hip. Orthopedics. 2010; 33:769.

5. Yoo JC, Koh KH, Park WH, Park JC, Kim SM, Yoon YC. The outcome of ultrasound-guided needle decompression and steroid injection in calcific tendinitis. J Shoulder Elbow Surg. 2010; 19:596–600.

6. King JW, Vanderpool DW. Calcific tendonitis of the rectus femoris. Am J Orthop. 1967; 9:110–1.

7. Seo YJ, Chang JD, Chang SK, Lee GK. Calcific tendinitis of the rectus femoris: a case report. J Korean Orthop Assoc. 2004; 39:343–6.

8. Mavrikakis ME, Drimis S, Kontoyannis DA, Rasidakis A, Moulopoulou ES, Kontoyannis S. Calcific shoulder periarthritis (tendinitis) in adult onset diabetes mellitus: a controlled study. Ann Rheum Dis. 1989; 48:211–4.

9. Uhthoff HK, Sarkar K, Maynard JA. Calcifying tendinitis: a new concept of its pathogenesis. Clin Orthop Relat Res. 1976; 118:164–8.

10. Gartner J, Simons B. Analysis of calcific deposits in calcifying tendinitis. Clin Orthop Relat Res. 1990; 254:111–20.

11. Hurt G, Baker CL Jr. Calcific tendinitis of the shoulder. Orthop Clin North Am. 2003; 34:567–75.

12. Goldenberg RR, Leventhal GS. Surpatrochanteric calcification. J Bone Joint Surg. 1936; 18:205–11.

13. Yang I, Hayes CW, Biermann JS. Calcific tendinitis of the gluteus medius tendon with bone marrow edema mimicking metastatic disease. Skeletal Radiol. 2002; 31:359–61.

14. Sarkar JS, Haddad FS, Crean SV, Brooks P. Acute calcific tendinitis of the rectus femoris. J Bone Joint Surg Br. 1996; 78:814–6.

15. Jones GB. Acute episodes with calcification around the hip joint. J Bone Joint Surg Br. 1955; 37:448–52.

16. Karpinski MR, Piggott H. Greater trochanteric pain syndrome. A report of 15 cases. J Bone Joint Surg Br. 1985; 67:762–3.

17. Sakai T, Shimaoka Y, Sugimoto M, Koizumi T. Acute calcific tendinitis of the gluteus medius: a case report with serial magnetic resonance imaging findings. J Orthop Sci. 2004; 9:404–7.

18. Choi JC, Kim YH, Na HY, et al. Treatment of calcific tendinitis around hip joint. J Korean Hip Soc. 2005; 17:83–7.

19. Faure G, Daculsi G. Calcified tendinitis: a review. Ann Rheum Dis. 1983; 42(Suppl 1):49–53.

20. Loew M, Daecke W, Kusnierczak D, Rahmanzadeh M, Ewerbeck V. Shock-wave therapy is effective for chronic calcifying tendinitis of the shoulder. J Bone Joint Surg Br. 1999; 81:863–7.

21. Gerdesmeyer L, Wagenpfeil S, Haake M, et al. Extracorporeal shock wave therapy for the treatment of chronic calcifying tendonitis of the rotator cuff: a randomized controlled trial. JAMA. 2003; 290:2573–80.