Tendinopathy and bursitis of the gluteal insertion is common
Mostle affects middle aged and elderly.
It also occurs in younger more athletic patients
perhaps as a consequence of core imbalance.
Although many of these patients are considered to have “trochanteric bursitis”, true trochanteric bursitis is less common than gluteus medius tendon and bursal disease
It is not uncommon to identify a small quantity of fluid in the region of the gluteus medius insertion.
Similarily, a small sliver of fluid in the trochanteric bursa is quite common
It is therefore mandatory that positive imaging findings in this region are correlated with clinical symptoms.
The trochanteric bursa is the most superficial and posterolateral of the many bursa that surround the hip joint.
When distended it is easily appreciated on axial T2 weighted images particularly with fat suppression.
It lies just below the level of the top of the greater trochanter and deep to the gluteus maximus and iliotibial band.
It is a large bursa and can extend significantly laterally and inferiorly.
The more commonly involved bursa is the sub gluteus medius bursa.
This bursa lies on the deep surface of the gluteus medius insertion.
It is also very easily appreciated on axial T2 weighted images particularly with fat suppression.
It lies in a more superior location than the trochanteric bursa.
Less common
Often overlooked as the GMax insertion is often lower that the usual hip FOV
Calcification not uncommon at enthesis
