Unilateral Hypertrophy of the Tensor Fascia Lata

Abstract

A 57-year-old woman presented with right hip pain. The initial diagnosis was an inflammatory tendinopathy of the gluteus medius without signs of rupture, and the patient underwent an ultrasound-guided corticosteroid injection. However, 1 month later, she presented with a painful swelling on the anterior-external aspect of the right hip/thigh, with a clinical suspicion of malignancy. Magnetic resonance imaging (MRI) scan and ultrasound confirmed the diagnosis of hypertrophy of the tensor fascia lata (TFL) muscle . It is included in the differential diagnosis of soft tissue masses of the anterolateral proximal part of the thigh. The etiology is likely to be associated with gluteal muscle dysfunction. Teaching point: Unilateral hypertrophy of the fascia lata consists of an association with hypertrophy of the tensor fascia lata muscle and pathology of the minimus and medius gluteus muscles.

Keywords: MRI; Tensor fascia lata; gluteus tendinopathy; ultrasound.

Figure 1

The sequence axial T1 shows the hypertrophic tensor fascia lata (white) on the right (surface: 1.855 mm²) compared to the left side (surface: 789 mm²).

Figure 2

Coronal pelvic MRI demonstrates evidence of significant fatty atrophy of the right gluteus muscles compared to the left side.