The Orthobiologic Institute (TOBI) Alumni Guillermo Alvarez Rey Publishes New Study in the British Journal of Sports Medicine:
Guillermo Alvarez Ray, The Orthobiologic Institute (TOBI) Alumni, recently published a new article in the British Journal of Sports Medicine titled Non-Insertional Tensor Fascia Lata Tendinopathy: Atypical Presentation and Undescribed us Findings. The study examined two clinical cases of chronic groin pain secondary to Tensor Fascia Lata (TFL) tendinopathy.
The two cases were both active males ages 30 and 39, who presented with chronic pain and difficulty with running. The main area of pain was identified as the proximal anterolateral region of the thigh, correlating with the TFL tendon. Both men had MRI imaging, which revealed no evidence of damage to the Tensor Fascia Lata tendon. Ultrasound studies were performed specifically for the TFL tendons, and images were obtained in both longitudinal and transverse planes.
The results of the ultrasound studies revealed interesting findings. In both cases, the proximal “insertional” portion of the TFL tendon on the injured side presented normal in size and echogenicity compared to the contralateral healthy tendon. However, examination of the main body or “noninsertional” portion of the proximal TFL tendon revealed changes indicative of injury. One of the cases (39 yrs.) showed simply a large increased size, while the other patient (30 yrs.) showed a focal spindle or fusiform shape as a focal tendinopathy with hipoechogenicity appearance.
This study illustrates an undescribed and atypical presentation of proximal TFL tendinopathy. In previous studies, point tenderness in the proximal TFL has been commonly described in ultrasound as a possible “insertional” tendinopathy. However, this study presents two cases of proximal TFL tenderness that correlate with pathology to the “noninsertional” portion of the tendon, which is proximal to the greater trochanter of the Femur. This study sheds light on the benefit of meticulous ultrasound scanning for proximal TFL tendinopathies, including both the “insertional” and “noninsertional” portion of the proximal tendon. In addition, these case reports contribute to a growing volume of evidence supporting the benefit of musculoskeletal ultrasound for diagnostic purposes.
For all of the latest research on regenerative medicine and hands-on musculoskeletal ultrasound cadaver lab with Dr. Jay Smith, be sure to attend the 6th Annual TOBI: The Orthobiologic Institute PRP & Regenerative Medicine Symposium with Cadaver Lab June 12-14, 2015 in Las Vegas, www.prpseminar.com