A macroscopic anatomical study of the appropriate palpation zone of the gluteus medius muscle

Abstract

[Purpose] Few previous studies have delimitated the palpation zone of the gluteus medius muscle with a focus on its fiber bundles. The purpose of this study was to clarify the morphological characteristics of the gluteus medius muscle using an anatomical approach, and to define its proper palpation zone. [Participants and Methods] In this study, we evaluated thirteen halves of the pelvic region in seven formalin-fixed cadavers. We identified the borders between the iliotibial band and gluteus medius muscle, and between the gluteus medius and gluteus maximus muscles, on the iliac crest. Furthermore, we quantified the border points of the gluteus medius' fiber bundles and observed its anatomical and morphological characteristics. [Results] We identified two fiber bundles in the gluteus medius muscle, an anterior and a posterior fiber bundle, and detected that a portion of the posterior fibers was located subcutaneously. [Conclusion] We propose that the region where the posterior fibers of the gluteus medius muscle are located subcutaneously is an appropriate zone for the palpation of this muscle.

Keywords: Gluteus medius; Gross anatomy; Palpation.

Fig. 1.

A diagram showing the measurement points on the right iliac crest. ●: The border point between the iliotibial band (ITB) and the gluteus medius (GMed). 〇: The border point between the GMed and the gluteus maximus (GMax). : The iliac crest length: the length of the iliac crest from the anterior superior iliac spine (ASIS) to the posterior superior iliac spine (PSIS) along the iliac crest. : LAIB; The length from the ASIS to the posterior edge of the ITB. : LAGM; The length from the ASIS to the anterior edge of the GMax. GT: Great trochanter.

Fig. 2.

A diagram showing measurement of the border point of the fiber bundle of the right GMed on the iliac crest. 〇: The border point of the fiber bundle of GMed on the iliac crest. : LAFB; The length from ASIS to 〇

Fig. 3.

A photograph and a diagram showing the border of the fiber bundle of the right GMed.

Fig. 4.

A photograph and a diagram showing the structure of the the intramuscular tendon of the right GMed. The posterior edge of the anterior fiber was pinched up to show the intramuscular tendon and the distal tendon of the posterior fiber.

Fig. 5.

Diagram of the zone where the posterior GMed fibers can be palpated subcutaneously (right lower limb). The posterior GMed fibers should be palpated slightly distal to the iliac crest (shaded area) between 62% and 83% of the iliac crest length, which is 100% of the length from the ASIS to the PSIS. Note that the iliac crest length is not the linear distance between ASIS and PSIS, but the length that follows the curve of the iliac crest.