The gluteal triangle: A clinical patho-anatomical approach to the diagnosis of gluteal pain in athletes

British Journal of Sports Medicine

Volumn 43, Issue 6, 2009, Pages 460-466

  Franklyn Miller, A ^a,b   Falvey, E ^a,b   McCrory, P ^a  

^a UNIVERSITY OF MELBOURNE   (Australia)

^b OLYMPIC PARK SPORTS MEDICINE CENTRE   (Australia)

Author keywords

[No Author keywords available]

Indexed keywords

ANTHROPOMETRY; ATHLETE; CLINICAL FEATURE; DIFFERENTIAL DIAGNOSIS; GLUTEAL PAIN; GLUTEUS MAXIMUS MUSCLE; HUMAN; MYALGIA; REVIEW; TIBIA TUBEROSITY;

BUTTOCKS; CHRONIC DISEASE; HUMANS; MUSCLE, SKELETAL; MUSCULAR DISEASES; PAIN; SPORTS;

EID: 67249092133     PISSN: 03063674     EISSN: 14730480     Source Type: Journal    
DOI: 10.1136/bjsm.2007.042317     Document Type: Review

References (61)

1. Lawrence JP, Greene HS, Grauer JN. Back pain in athletes. J Am Acad Orthop Surg 2006;14:726-735
2. Franklyn-Miller A, Falvey E, McCrory P, et al. Landmarks for the 3G approach: groin, gluteal and greater trochanter triangles: a patho-anatomical method in sports medicine. Eur J Anat 2008;12:81-88
3. Last R, Suinnatamby C. Last's anatomy: regional and applied. 10th Edition ed. London: Churchill Livingstone 1999.
4. Franklyn-Miller A, Falvey E, McCrory P, et al. The morphology of the deep fascia of the lower limb. submitted to J Bodyw, Mov Ther.
5. Windisch G, Braun EM, Anderhuber F. Piriformis muscle: clinical anatomy and consideration of the piriformis Syndrome. Surg Radiol Anat 2007;29:37-45.
6. Anderson LC, Gerrard DF. Ethical issues concerning New Zealand sports doctors. J Med Ethics. 2005;31:88-92.
7. Iglehart JK. The new era of medical imaging - progress and pitfalls. N Engl J Med 2006;354:2822-2828
8. Bowen JL. Educational strategies to promote clinical diagnostic reasoning. N Engl J Med 2006;355:2217-2225
9. Bruckner P, Khan KM. Clinical sports medicine. 3rd ed. Australia: McGraw-Hill 2007.
10. Malanga G, Nadler S. Musculoskeletal physical examination. An evidence-based approach. 1st ed. Philadelphia: Elsevier Mosby 2006.
11. Hancock MJ, Maher CG, Latimer J, et al. Systematic review of tests to identify the disc, SIJ or facet joint as the source of low back pain. Eur Spine J 2007;16:1539-1550
12. Solonen KA. The sacroiliac joint in the light of anatomical, roentgenological and clinical studies. Acta Orthop Scand Suppl 1957;27:1-127.
13. Laslett M, Williams M. The reliability of selected pain provocation tests for sacroiliac joint pathology. Spine 1994;19:1243-1249
14. Boswell MV, Shah RV, Everett CR, et al. Interventional techniques in the management of chronic spinal pain: evidence-based practice guidelines. Pain Physician 2005;8:1-47.
15. Warrell D, Cox TM, Firth J, Benz E, Isner-Horobeti M. Oxford textbook of medicine. Oxford University Press 2004.
16. Lourie H. Spontaneous osteoporotic fracture of the sacrum. An unrecognized syndrome of the elderly. JAMA 1982;248:715-717
17. Ryan PJ, Fogelman I. The role of nuclear medicine in orthopaedics. Nucl Med Commun 1994;15:341-360
18. Berger FH, de Jonge MC, Maas M. Stress fractures in the lower extremity. The importance of increasing awareness amongst radiologists. Eur J Radiol 2007;62:16-26.
19. Bradshaw C, McCrory P. Obturator nerve entrapment. Clin J Sport Med 1997;7:217-219
20. Delagi EF PA. Anatomic guide for the electromyographer. 2nd ed. Springfield: Charles C Thomas Publishers, 1980.
21. Magora F, Rozin R, Ben-Menachem Y, et al. Obturator nerve block: an evaluation of technique. Br J Anaesth 1969;41:695-698
22. Oseto MC, Edwards JZ, Acus RW 3rd. Posterior thigh compartment syndrome associated with hamstring avulsion and chronic anticoagulation therapy. Orthopedics 2004;27:229-230
23. Kwong Y, Patel J, Ramanathan EB. Spontaneous complete hamstring avulsion causing posterior thigh compartment syndrome. Br J Sports Med 2006;40:723-4; discussion 4.
24. Brandser EA, el-Khoury GY, Kathol MH, et al. Hamstring injuries: radiographic, conventional tomographic, CT, and MR imaging characteristics. Radiology 1995;197:257-262
25. Orava S, Laakko E, Mattila K, et al. Chronic compartment syndrome of the quadriceps femoris muscle in athletes. Diagnosis, imaging and treatment with fasciotomy. Ann Chir Gynaecol 1998;87:53-58
26. Batt M, Baque J, Bouillanne PJ, et al. Percutaneous angioplasty of the superior gluteal artery for buttock claudication: a report of seven cases and literature review. J Vasc Surg 2006 May;43:987-991
27. Berthelot JM, Pillet JC, Mitard D, et al. Buttock claudication disclosing a thrombosis of the superior left gluteal artery: Report of a case diagnosed by a selective arteriography of the iliac artery, and cured by per-cutaneous stenting. Joint Bone Spine 2007;74:289-291
28. Puranen J, Orava S. The hamstring syndrome. A new diagnosis of gluteal sciatic pain. The American journal of sports medicine 1988;16:517-521
29. Orava S. Hamstring syndrome. Oper Tech Sports Med 1997;5:143.
30. Lavelle ED, Lavelle W, Smith HS. Myofascial trigger points. Med Clin North Am 2007;91:229-239
31. Njoo KH, Van der Does E. The occurrence and inter-rater reliability of myofascial trigger points in the quadratus lumborum and gluteus medius: a prospective study in non-specific low back pain patients and controls in general practice. Pain 1994;58:317-323
32. Ozcakar L, Erol O, Kaymak B, et al. An underdiagnosed hip pathology: apropos of two cases with gluteus medius tendon tears. Clin Rheumatol 2004;23:464-466
33. Bird P, Oakley S, Shnier R, et al. Prospective evaluation of magnetic resonance imaging and physical examination findings in patient with trochanteric pain syndrome. Arthritis Rheum 2001;44:2138-2145
34. Allen GM, Wilson DJ. Ultrasound in sports medicine--a critical evaluation. Eur J Radiol 2007;62:79-85.
35. Aihara T, Takahashi K, Yamagata M, et al. Biomechanical functions of the iliolumbar ligament in L5 spondylolysis. J Orthop Sci 2000;5:238-242
36. Pool-Goudzwaard A, Hoek van Dijke G, Mulder P, et al. The iliolumbar ligament: its influence on stability of the sacroiliac joint. Clin Biomech (Bristol, Avon)2003;18:99-105.
37. Paluska SA. An overview of hip injuries in running. Sports Med 2005;35:991-1014.
38. Walker P, Kannangara S, Bruce WJ, et al. Lateral hip pain: does imaging predict response to localized injection? Clin Orthop Relat Res 2007;457:144-149
39. Brignall CG, Brown RM, Stainsby GD. Fibrosis of the gluteus maximus as a cause of snapping hip. A case report. J Bone Joint Surg Am 1993;75:909-910
40. Malanga GAN, S F. Physical examination of the hip. Muscloskeletal physical examination, an evidence-based approach. Philadelphia, PA: Elsevier Mosby, 2006:251-279
41. Ganz R, Parvizi J, Beck M, et al. Femoroacetabular impingement: a cause for osteoarthritis of the hip. Clin Orthop Relat Res 2003;(417):112-120
42. Leunig M, Podeszwa D, Beck M, et al. Magnetic resonance arthrography of labral disorders in hips with dysplasia and impingement. Clin Orthop Relat Res 2004;(418):74-80.
43. Birrell F, Croft P, Cooper C, et al. Predicting radiographic hip osteoarthritis from range of movement. Rheumatology (Oxford) 2001;40:506-512
44. Monteleone GP, Jr. Stress fractures in the athlete. The Orthopedic clinics of North America 1995;26:423-432
45. Johnson AW, Weiss CB Jr, Wheeler DL. Stress fractures of the femoral shaft in athletes - more common than expected. A new clinical test. Am J Sports Med 1994;22:248-256
46. Seror P, Seror R. Meralgia paresthetica: clinical and electrophysiological diagnosis in 120 cases. Muscle & nerve 2006;33:650-654
47. Rab M, Ebmer And J, Dellon AL. Anatomic variability of the ilioinguinal and genitofemoral nerve: implications for the treatment of groin pain. Plast Reconstr Surg 2001;108:1618-1623
48. Andersson G, Deyo R. History and examination in patients with herniated lumbar discs. Spine 1996;21(Suppl 24):10-8S.
49. Stankovic R, Johnell O, Maly P, et al. Use of lumbar extension, slump test, physical and neurological examination in the evaluation of patients with suspected herniatednucleus pulposus;a prospective clincal study. Man Ther 1999;4:25-32.
50. Manchikanti L, Cash KA, Pampati V, et al. Evaluation of fluoroscopically guided caudal epidural injections. Pain Physician 2004;7:81-92.
51. Revel M, Poiraudeau S, Auleley GR, et al. Capacity of the clinical picture to characterize low back pain relieved by facet joint anesthesia. Proposed criteria to identify patients with painful facet joints. Spine 199815;23:1972-1976; discussion 7.
52. Beatty RA. The piriformis muscle syndrome: a simple diagnostic maneuver. Neurosurgery 1994;34:512-4; discussion 4.
53. Solheim L, Siewars P, Paus B. The Piriformis muscle syndrome; sciatic nerve entrapment treated with section of the piriformis muscle. Acta Orthp Scand 1981;52:73-75
54. Smith J, Hurdle MF, Locketz AJ, et al. Ultrasound-guided piriformis injection: technique description and verification. Arch Phys Med Rehabil 2006;87:1664-1667
55. Hetrick DC, Ciol MA, Rothman I, et al. Musculoskeletal dysfunction in men with chronic pelvic pain syndrome type III: a case-control study. J Urol 2003;170:828-831
56. Papastergiou S, Koukoulias N, Tsitouridis I, et al. Circumflex femoral vein thrombosis misinterpreted as acute hamstring strain. Br J Sports Med 2007;41:460-461
57. Verrall GM, Slavotinek JP, Barnes PG, et al. Diagnostic and prognostic value of clinical findings in 83 athletes with posterior thigh injury: comparison of clinical findings with magnetic resonance imaging documentation of hamstring muscle strain. Am J Sports Med 2003;31:969-973
58. Askling CM, Tengvar M, Saartok T, et al. Acute first-time hamstring strains during high-speed running: a longitudinal study including clinical and magnetic resonance imaging findings. Am J Sports Med 2007;35:197-206.
59. Rossi F, Dragoni S. Acute avulsion fractures of the pelvis in adolescent competitive athletes: prevalence, location and sports distribution of 203 cases collected. Skeletal Radiol 2001;30:127-131
60. Clanton TO, Coupe KJ. Hamstring strains in athletes: diagnosis and treatment. J Am Acad Orthop Surg 1998;6:237-248
61. Lequesne M, Zaoui A. [Misleading "hip" or buttock pain: proximal arteritis or lumbar spinal stenosis?]. Presse Med 2006;35:663-668