Ultrasound-Guided Percutaneous Needle Tenotomy with Platelet-Rich Plasma Injection for an Uncommon Case of Proximal Gluteus Medius Tendinopathy

摘要

A 40-year-old female modern dancer presented with pain and tenderness at the lateral aspect of the left hip for 6 months. The pain was initially noticed during her performance and then aggravated, making her difficult to perform certain dancing postures. During the physical examination, a specific tender point was palpated on the left lateral iliac crest (IC) [Figure 1 a]. The ultrasound (US) examination revealed focal swelling and hypoechoic at the proximal gluteus medius (GMed) attachment on the IC [Figure lb and c]. Proximal GMed tendinopathy was impressed. US-guided percutaneous needle tenotomy (PNT) and injection with hypertonic dextrose (prolotherapy) were performed on the lesion for two times with a 1-month interval, and the patient reported limited improvement. One month after the second treatment, another US-guided PNT and injection of platelet-rich plasma (PRP) were performed [Figure 1d], and she finally had significant symptom relief.