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Gluteus medius muscle

The gluteus medius is a broad, fan-shaped muscle of the lateral hip, forming the middle layer of the gluteal musculature. It originates from the outer surface of the ilium, between the anterior and posterior gluteal lines, and inserts on the lateral surface of the greater trochanter of the femur.

It lies deep to the gluteus maximus and superficial to the gluteus minimus, creating a functional and structural continuum with both. The gluteus minimus mirrors its anatomy and works in synergy for hip abduction and internal rotation, while the gluteus maximus overlies it superficially, contributing to extension and external rotation. Together, these three muscles form the gluteal group, essential for hip stability, locomotion, and posture.

The gluteus medius has anterior, middle, and posterior fibers, each with slightly different actions, making it a versatile stabilizer of the hip joint. Clinically, it is critical in gait: dysfunction or tear produces the Trendelenburg sign, where the pelvis drops on the unsupported side. It is also a major focus in greater trochanteric pain syndrome, tendon tears, and athletic injuries.

Synonyms

  • Musculus gluteus medius

  • Middle gluteal muscle

  • Hip abductor muscle

Function

  • Primary abductor of the thigh at the hip joint

  • Anterior fibers: medial rotation and flexion of the thigh

  • Posterior fibers: lateral rotation and extension of the thigh

  • Maintains pelvic stability during locomotion (prevents Trendelenburg gait)

Nerve Supply

  • Superior gluteal nerve (L4, L5, S1)

Arterial Supply

  • Superior gluteal artery (primary supply)

  • Anastomotic contributions from the lateral circumflex femoral artery

Venous Drainage

  • Superior gluteal vein → internal iliac vein

  • Connections with circumflex femoral venous plexus

MRI Appearance

T1-weighted images:

  • Normal muscle shows intermediate signal intensity with fascicular pattern

  • Fat between fascicles appears hyperintense

T2-weighted images:

  • Normal gluteus medius: intermediate-to-low signal

  • Pathology (edema, strain, tendon tear) shows hyperintense signal

STIR:

  • Suppresses fat, highlighting muscle edema, tears, or peritendinous inflammation as hyperintense regions

  • Sensitive for gluteal tendinopathy and bursitis

T1 Fat-Saturated (Pre-contrast):

  • Muscle shows intermediate signal standing out against suppressed fat planes

  • Useful for subtle muscle and tendon changes

T1 Fat-Saturated Post-Contrast (Gadolinium):

  • Normal muscle enhances mildly and homogeneously

  • Pathology (myositis, tendon tear, tumor, or bursitis) shows heterogeneous enhancement

MRI Non-Contrast 3D Imaging:

  • Provides 3D assessment of muscle bulk, tendon integrity, and insertion at greater trochanter

  • Useful in pre-surgical tendon repair planning

CT Appearance

Non-contrast CT:

  • Muscle appears as a soft-tissue density lateral to ilium and femur

  • Useful for detecting calcifications, atrophy, or fatty infiltration

CT Post-Contrast:

  • Enhances muscle vascularity

  • Helps detect neoplasms, abscesses, or inflammatory changes involving gluteus medius

  • Assists in surgical and interventional planning

MRI images

Gluteus medius muscle MRI coronal image anatomy image -img-00000-00000

MRI images

Gluteus medius muscle MRI coronal image anatomy image -img-00000-00000_00001

MRI images

Gluteus medius muscle MRI coronal image anatomy image -img-00000-00000_00002

CT images

Gluteus medius muscle ct axial image 1

CT images

Gluteus medius muscle ct axial image

CT image

Gluteus medius muscle CT coronal image anatomy i