Best Imaging Modality for Gluteal Muscle Tear ????

[JUD2SKI]

Am dealing with a Severe Gluteal Muscle Tear with proximal retraction; coupled with Hamstring tears at proximal attachment to the Ischial Tuberosity.....................What is the BEST IMAGING MODALITY to utilize injury prior to surgery and why????   Should I be considering MRI with the strictest of protocols or is Diagnostic "positional" ULTRASOUND  the better choice????????????    Input requested as soon as possible!!!      Thank You.
                                                                                                                                                JUD2SKI

[Dr Vinod]

After the hip replacement your surgeon can always have a scan to find out that there is a Gluteal tear or not. Even by your symptoms and his experience on examination he has to diagnose your problem. If your chiropractor and your surgeon think that you do not have a tear and it is due to nerve compression pain and your pain not getting relieved, you should request them to convince you that it is not gluteal tear pain. Physiotherapy is very important and so are anti inflammatory drugs and ask your surgeon to prescribe enough pain killers. Take care!

[JUD2SKI]

Hello.......
    Just wanted to provide a direction of travel for you.  You might want to investigate all of the possibilities of MR-Neurography with Dr. Aaron Filler and research the possibilities of "Piriformis Syndrome" on some web search and see how your symptoms relate to this diagnosis.  Dr. Filler is a world known expert on nerve entrapment senarios that most neurosurgeons will not even admit to even the existence of.  Talk with me some more if you need additional direction and questions answered for my life for the past 4 years has been nothing but medical research on this particular area of anatomy and the various Imaging Modalities tried and failed.  Drop me a line at any time if you wish to.
                                                                                 JUD2SKI

[C3C]

How do I get my surgeon who did my left hip replacement, to look at my right buttock pain with the idea there may be a severe strain or tear instead of osteoarthritic problems (which I do have) or my Chriopractor who insists I have a pinched nerve in L4-L5 and is treating me with stimulation and manipulation. These two things are not helping and I am in a position where I cannot walk now. The pain is extruciating.
I couldn't be more sure of having a diagnosis as I am about a gluteal strain or tear, but they won't invistigate it. I am 49 today.

[dr_simran]

Hello JUD2SKI,
The best option and choice for gluteal maximus tear is MRI as it reveals the anatomical relations best with the adjoining structures. Definitely it is more specific and sensitive investigation than an ultrasound.
Best