Sonographic findings of tensor fascia lata tendinopathy: another cause of anterior groin pain

Abstract

Objective: To describe the sonographic appearances of the normal tensor fascia lata (TFL) origin and to describe the sonographic changes that were present in the TFL of a group of athletes presenting with anterior groin pain. Design: The sonographic appearances of the TFLs of 40 healthy asymptomatic volunteers were evaluated. The TFLs of approximately 200 patients aged between 16 and 55 years presenting with anterior groin pain were evaluated in the course of routine sonographic assessment of the hip. Twelve abnormal TFLs were identified in 12 patients aged between 16 and 53 years. A retrospective review of the appearance of the normal and abnormal tendon with respect to its overall size and echotexture was made. Results: The normal TFL has a thin ribbon-like appearance with a clearly defined fibrillar pattern and a mean anteroposterior (AP) size of 2.1 mm (range 1.5–3.1 mm). In the patient cohort the TFL typically appeared enlarged and contained a cone-shaped area of hypoechogenicity based on the iliac crest within the deep fibers of the origin. The TFL origin was enlarged up to 2 1/2 times its normal size. The mean AP size of the abnormal TFL was 4.7 mm (range 3.1–7.0 mm). Conclusion: Tendinopathy of the TFL is a cause of anterior groin pain. Sonography can be used to depict changes in the TFL, confirming the diagnosis and assessing the severity of the tendinopathy.