Male 59 years old Reason: evaluate for gluteus medius tear History: lateral hip pain. Evaluation of the bone and soft tissues of the hips is limited by metallic susceptibility artifact from bilateral total hip arthroplasties. There is also metallic susceptibility artifact anteriorly within the pelvis, perhaps due to components of a penile prosthesis.The main and lateral tendons of the left gluteus medius can be followed to their insertions on the greater trochanter. We see no gluteus medius tear. The gluteus minimus appears thinned. Its tendinous insertion is difficult to visualize due to the aforementioned metal artifact, but we suspect it is intact and we see no abnormal signal or edema in the vicinity of the tendon to suggest a tear. The visualized components of the gluteus maximus muscles are intact. There is moderate atrophy of the psoas muscle on the left. We see no specific findings to suggest complications of either hip prosthesis. Mild degenerative disk disease and facet joint osteoarthritis affect the lower lumbar spine and we suspect that there is narrowing of the spinal canal; this would be better assessed with a lumbar spine MRI if clinically warranted. The sacroiliac joints appear normal. The remaining musculature of the left hip is unremarkable. Grossly, the musculature of the right hip seen on the large field of view images is unremarkable, although the gluteus minimus muscle appear slightly atrophic.
1.Limited evaluation due to susceptibility metallic artifact from prostheses. Given this limitation, we see no muscle tears; specifically, the gluteus medius appears intact.2.Degenerative arthritic changes of the lower lumbar spine could be better assessed with dedicated lumbar spine MRI if clinically warranted.3.Atrophy of the left psoas muscle.