Gluteal region and back of the thigh

Applied Anatomy
Trendlenberg's gait
When any of the features of lateral balance control fails, the supporting is upset. The pelvis
tends to fall on the unsupported side when the individual stands on the affected limb. This is
called Trendelenberg sign. The person walks with a characteristic lurching or waddling gait.
In A : Negative trendlenberg's test . The hip abductors are acting normally tilting the pelvis upwards
when the opposite leg is raised from the ground
In B : Positive Trendelenberg's test . The hip abductors are unable to control the dropping of the pelvis
when the opposite leg is raised
Causes of such a condition include:
Paralysis of the gluteus minimus and medius
Dislocation of the hip joint
Fractures of the neck of the femur
Collapse of the head of the femur e.g. from avascular necrosis, slipped epiphysis,
tuberculosis of head of femur
Severe arthritis of the hip joint


Sciatic nerve
Can be compressed at lower border of gluteus maximus by sitting on a bench with a sharp
edge.
May be injured by misplaced deep intravascular injections. To prevent this, the injection is
usually given in the superolateral quadrant.
May be injured in posterior dislocation of the hip joint.


Sciatic Hernia
Pelvic structures may protrude through the greater sciatic foramen. This is called sciatic hernia. It compresses the
contents of the foramina and may present with pain, numbness and weakness in the lower limb if sciatic nerve is
compressed.

Trochanteric bursitis
The extensive bursa between the great trochanter and the gluteal aponeurosis may be a site of infection. Patient
complains of pain and swelling in the trachanteric region. Sometimes there may be a pus discharge.

Snapping hip
In this condition, a snap is heard and felt on certain hip movements. The snap is attributed to slipping of a tendinous