The Modified Resisted Internal Rotation Test for Detection of Gluteal Tendon Tears  Rafael Walker-Santiago, M.D., Victor Ortiz-Declet, M.D., David R. Maldonado, M.D., Natalia M. Wojnowski, B.S., Benjamin G. Domb, M.D.  Arthroscopy Techniques  Volume 8, Issue 3, Pages e331-e334 (March 2019) DOI: 10.1016/j.eats.2018.11.006 Copyright © 2019 Arthroscopy Association of North America Terms and Conditions

Fig 1 (A) While the patient is in the supine position, the affected left hip and knee are positioned at 90° of flexion. The affected hip is then externally rotated 15° while the contralateral right hip and knee remain in full extension. (B) Positioning of the patient with 15° of external rotation of the left hip for the starting position of the maneuver. This femoral derotational positioning is important to increase tension on the internal rotators of the hip and increase the accuracy of the test. Arthroscopy Techniques 2019 8, e331-e334DOI: (10.1016/j.eats.2018.11.006) Copyright © 2019 Arthroscopy Association of North America Terms and Conditions

Fig 2 The examiner should place one hand on the medial aspect of the knee while the other hand is placed on the lateral aspect of the ankle to provide a resistive force, as shown here for the left lower extremity. Then, the patient is asked to simultaneously internally rotate (a) and adduct (b) the hip. In this manner, hip flexion decreases the contribution of the tensor fascia lata, whereas 15° of external rotation increases the tension on the gluteus medius to favor detection of gluteal tendinopathy. Arthroscopy Techniques 2019 8, e331-e334DOI: (10.1016/j.eats.2018.11.006) Copyright © 2019 Arthroscopy Association of North America Terms and Conditions