Deep Gluteal Space Anatomy, Pathology, Clinical Presentation, and Management

The deep gluteal space is a complex anatomic region associated with posterior hip symptoms. The clinical presentation involves symptoms and signs attributable to the deep gluteal space itself, in addition to other periarticular structures. Imaging involves both 2 and 3 dimensional modalities. Collision-detection software may be highly valuable for dynamic assessment. Nonsurgical treatment involves education-driven activity modification and physical therapy, combined with medications and selective injections. Surgical treatment involves endoscopic or open management, performed in isolation or combination with other hip procedures (eg, total hip arthroplasty, gluteus medius repair, lesser trochanterplasty, ischioplasty, derotational osteotomy) either simultaneously or in staged fashion.