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DOI:10.2214/AJR.07.2513
AJR 2008; 190:1616-1620
© American Roentgen Ray Society

Clinical Observations

Stress-Related Injuries Around the Lesser Trochanter in Long-Distance Runners

Josephine T. Nguyen1, Jeffrey S. Peterson2, Sandip Biswal3, Christopher F. Beaulieu3 and Michael Fredericson4

1 Magnetic Resonance Imaging, Radiology, Long Beach Memorial Medical Center, Long Beach, CA.
2 Innovative Sports Medicine, Mountain View, CA.
3 Department of Radiology, Stanford University Medical Center, Stanford, CA.
4 Division of Physical Medicine and Rehabilitation, Department of Orthopaedic Surgery, Stanford University Medical Center, 300 Pasteur Dr., Edwards Bldg. R107A, Stanford, CA 94305-5336.

OBJECTIVE. Imaging abnormalities around the lesser trochanter are occasionally found in long-distance runners, yet little research has been conducted concerning this area of the hip. In addition, the relation between iliopsoas insertional abnormalities at the lesser trochanter and femoral neck stress injuries has not been examined, to our knowledge. We report MRI findings at the lesser trochanter in nine long-distance runners with hip or groin pain and a consistent constellation of the following findings: abnormalities associated with the iliopsoas tendon and its insertion, including marrow edema at the lesser trochanter; periostitis around the lesser trochanter; and bone marrow edema in the femoral neck. One case involved temporal progression to a cortical fracture.

CONCLUSION. Long-distance runners with hip or groin pain and abnormal MRI findings involving the insertion of the iliopsoas tendon and marrow edema in the lesser trochanter may be at risk of stress injuries at the femoral neck.

Keywords: femoral neck • iliopsoas • MRI • musculoskeletal • stress injuries


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