What’s the Diagnosis – Case 123
1
What’s the Diagnosis – Case 123
2
What’s the Diagnosis – Case 123
3
What’s the Diagnosis – Case 123
4
What’s the Diagnosis – Case 123
5
What’s the Diagnosis – Case 123
6
What’s the Diagnosis – Case 123
7
Findings At the area of the perceived mass, there is a focal prominence that has signal intensity following muscle on all pulse sequences. There was no interval change in the architecture of the mass and no enlargement. There is severe left sided posterior band gluteus medius tendinois and a long standing disruption of the anterior lateral band of the gluteus medius. Not shown was a long standing disruption of the left gluteus minimus. There is marked fatty infiltration of the left sided glutes minimus and anterolateral fibers of the gluteus medius, particularly conspicuous when comparing to the right side.
What’s the Diagnosis – Case 123
8
What’s the Diagnosis – Case 123
9
What’s the Diagnosis – Case 123
10
What’s the Diagnosis – Case 123
11
What’s the Diagnosis – Case 123
12
Diagnosis: Tensor Fascia Latae Pseudomass A rare diagnosis and frankly one I did not know existed until this case. Found typically in older women it is thought to arise in the setting of abnormal gait that produces a hypertrophy of the tensor fascia latae. It is most typically found in the setting of total hip arthroplasty with deficient hip abductors. Although no arthroplasty is present in this case, there is clear deficiency of the hip abductors. The thought is that there is a compensatory hypertrophy of the tensor fascia latae to accommodate/mitigate the effects of the deficient hip abductors.
What’s the Diagnosis – Case 123
13
References Unilateral hypertrophy of tensor fascia lata: a soft tissue tumor simulator. Ilaslan H, Wenger DE, Shives TC, Unni KK. Skeletal Radiol. 2003 Nov;32(11):628-32. Epub 2003 Sep 30. Hypertrophy of the tensor fascia lata muscle as a complication of total hip arthroplasty. Rodríguez-Roiz JM, Bori G, Tomas X, Fernández-Valencia JA, García-Díez AI, Pomés J, Garcia S. Eur J Orthop Surg Traumatol. 2017 Feb;27(2):255-259. doi: 10.1007/s00590-016-1854-z. Epub 2016 Sep 19. Very special thank you to Christian Geanette, MD for his help with this case.
What’s the Diagnosis – Case 123
14