Ultrasound Diagnosis and Novel Surgical Management of Iliac Crest Enthesopathy

Iliac crest enthesopathy is an uncommon cause of function-limiting lateral hip pain with limited literature addressing its diagnosis and management. We present a case series of 8 adult patients with iliac crest/proximal gluteal pathology (6 degenerative, 1 posttraumatic, and 1 neoplastic) that highlights diagnostic challenges in this region. Our cases demonstrate the utility of musculoskeletal ultrasonography in both diagnosis and treatment of iliac crest enthesopathy. After reviewing relevant literature, we describe a novel ultrasound-guided surgical approach used in 5 patients in whom conservative therapies failed. This technique offers a minimally invasive alternative for managing recalcitrant iliac crest enthesopathy.