Female 55 years old; Evaluate for bursitis or gluteal muscle tears around the right hip. Severe pain for years (since 2005) near the greater trochanter, with acute worsening in the past 4 months. The examination is limited by lack of complete series of sequences as the patient was not able to tolerate positioning. Moderate osteoarthritis affects the right hip. There is diffuse thinning of the articular cartilage superiorly and focal full thickness degeneration anteriorly with associated cyst formation at the anterior acetabular dome. Additional edema type signal within the acetabular dome is likely reactive though the possibility of a stress reaction is also considered. We see no discrete fracture line. There is suspicion of an incomplete tear of the anterior superior labrum; however, the labrum is not fully visualized due to the aforementioned limitations of the study. The ligamentum teres is intact. Small amount of fluid and/or synovitis is present in the right hip. The gluteal musculature appears normal, as does the remaining musculature of the right hip. We see no gluteal muscle tear. Minimal edema type signal is present along the posterior aspect of the greater trochanter at the gluteus medius insertion, which is of questionable clinical significance and may be seen in asymptomatic patients. Similar, if not more prominent, edema type signal is present on the left, which is also of questionable clinical significance. A small focus of increased signal at the ischium along the origin of the right hamstring muscles may indicate a small tear, however, this may also be seen in asymptomatic patients. More prominent signal abnormality is present on the left at the hamstring origin and may also reflect prior tearing, not necessarily of any current clinical significance.Moderate osteoarthritis affects the pubic symphysis. Mild osteoarthritis affects the left hip. A small amount of fluid signal at the anterior aspect of the left acetabulum may perhaps be in the iliopsoas bursa, though a paralabral cyst is also a possibility. Severe degenerative disk disease affects the L4/5 level. Sacralization of L5 is again seen. Moderate facet joint hypertrophy is present in the lower lumbar spine with spinal stenosis, which may be better evaluated with dedicated lumbar spine MRI, if clinically warranted.
1. Osteoarthritis of the right hip, as above. Edema within the acetabular dome is probably degenerative in etiology, although a stress reaction is also considered. Degenerative changes of the left hip, pubic symphysis, and lower lumbar spine.2. No findings suggestive of gluteal muscle tear or frank bursitis. Minimal edema type signal along the greater trochanters bilaterally is not necessarily of any clinical significance. 3. Additional findings, as above. 