The greater trochanter has four distinct facets for rotator cuff-like insertions of the hip abductor and external rotator tendons: the superoposterior facet (gluteus medius posterior fibres), the anterior facet (gluteus minimus and gluteus medius anterior), the lateral facet (gluteus medius principal attachment), and the medial facet (piriformis and obturator internus). Understanding the four-facet anatomy of the greater trochanter guides accurate diagnosis and treatment of gluteal tendinopathy.
Greater trochanteric pain syndrome from gluteal tendinopathy targets the tendon-trochanter interface on the superoposterior and lateral facets. MRI and ultrasound localise the pathology to specific facets — superoposterior tears are most common and most symptomatic. Ultrasound-guided injection under the gluteus medius tendon at the superoposterior facet provides targeted treatment.
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