{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T05:49:28Z","timestamp":1782452968473,"version":"3.54.5"},"reference-count":27,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T00:00:00Z","timestamp":1782432000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:p>Calcific tendinitis commonly affects the rotator cuff; however, involvement of the deep insertion of the gluteus maximus is uncommon and has been described only in limited reports. Deep-seated hip lesions may be difficult to identify on plain radiographs, potentially resulting in delayed diagnosis. We report the case of a 53-year-old woman who presented with atraumatic lateral hip pain and restricted range of motion for 1 month, that was unresponsive to nonsteroidal anti-inflammatory drugs (NSAIDs). Plain radiograph findings were inconclusive. Magnetic resonance imaging (MRI) showed inflammatory edema surrounding the gluteus maximus insertion, and computed tomography (CT) with three-dimensional (3D) reconstruction identified a calcific deposit. Because of persistent pain, functional limitation, and confirmed deep peri-hip calcification, surgical intervention was selected after discussing nonoperative options. Thus, an imaging-guided peri-hip endoscopic debridement was performed under C-arm fluoroscopic guidance following CT and 3D lesion localization. Typical \u201ctoothpaste-like\u201d calcific material extruded from the lesion and was completely removed. Histopathological examination confirmed calcific tendinopathy, and postoperative CT verified complete removal of the lesion. At 6 weeks postoperatively, her pain had resolved, and hip function had markedly improved. This case also highlights an effective, imaging-guided diagnostic workflow for deep peri-hip calcific lesions when radiographic findings are inconclusive. Although a CT-planned, C-arm-assisted approach may facilitate rapid recovery, longer-term follow-up is required to evaluate durability, recurrence, tendon healing, and potential delayed complications.<\/jats:p>","DOI":"10.3389\/fsurg.2026.1805054","type":"journal-article","created":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T05:44:39Z","timestamp":1782452679000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: C-arm\u2013assisted peri-hip endoscopic debridement for calcific tendinitis at the deep insertion of the gluteus maximus"],"prefix":"10.3389","volume":"13","author":[{"given":"Nan","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Traditional Chinese Medicine, The First People's Hospital of Xiaoshan District, Xiaoshan Affiliated Hospital of Wenzhou Medical University","place":["Hangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gangfeng","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, The First People's Hospital of Xiaoshan District, Xiaoshan Affiliated Hospital of Wenzhou Medical University","place":["Hangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fangqi","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, The First People's Hospital of Xiaoshan District, Xiaoshan Affiliated Hospital of Wenzhou Medical University","place":["Hangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,26]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1007\/s11926-023-01106-9","article-title":"An update on the diagnosis and management of calcium crystal disease","volume":"25","author":"Flood","year":"2023","journal-title":"Curr Rheumatol Rep"},{"key":"B2","doi-asserted-by":"publisher","first-page":"168","DOI":"10.1097\/BOR.0000000000000477","article-title":"Basic calcium phosphate crystal-associated musculoskeletal syndromes: an update","volume":"30","author":"Rosenthal","year":"2018","journal-title":"Curr Opin Rheumatol"},{"key":"B3","doi-asserted-by":"publisher","first-page":"2678","DOI":"10.3390\/diagnostics13162678","article-title":"Hydroxyapatite deposition disease: a comprehensive review of pathogenesis, radiological findings, and treatment strategies","volume":"13","author":"Hegazi","year":"2023","journal-title":"Diagnostics (Basel)"},{"key":"B4","doi-asserted-by":"publisher","first-page":"229","DOI":"10.1007\/s10140-024-02212-6","article-title":"Hydroxyapatite deposition disease, an overlooked differential diagnosis in the emergency department: a case series and review of literature","volume":"31","author":"Patel","year":"2024","journal-title":"Emerg Radiol"},{"key":"B5","doi-asserted-by":"publisher","first-page":"3748","DOI":"10.1016\/j.radcr.2024.05.086","article-title":"Calcific tendinitis of gluteus maximus insertion","volume":"19","author":"Tran","year":"2024","journal-title":"Radiol Case Rep"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1099","DOI":"10.1093\/bjr\/tqae039","article-title":"Imaging of calcific tendinopathy: natural history, migration patterns, pitfalls, and management: a review","volume":"97","author":"Saran","year":"2024","journal-title":"Br J Radiol"},{"key":"B7","doi-asserted-by":"publisher","first-page":"641","DOI":"10.1016\/j.rcl.2022.03.007","article-title":"Imaging of crystal disorders: calcium pyrophosphate dihydrate crystal deposition disease, calcium hydroxyapatite crystal deposition disease and gout pathophysiology, imaging, and diagnosis","volume":"60","author":"Reijnierse","year":"2022","journal-title":"Radiol Clin North Am"},{"key":"B8","doi-asserted-by":"publisher","first-page":"108653","DOI":"10.1016\/j.ejrad.2019.108653","article-title":"Calcium hydroxyapatite deposition disease: imaging features and presentations mimicking other pathologies","volume":"120","author":"Hongsmatip","year":"2019","journal-title":"Eur J Radiol"},{"key":"B9","doi-asserted-by":"publisher","first-page":"1553","DOI":"10.1007\/s00256-022-04006-8","article-title":"Acute calcific periarthritis-a commonly misdiagnosed pathology","volume":"51","author":"Dimmick","year":"2022","journal-title":"Skeletal Radiol"},{"key":"B10","doi-asserted-by":"publisher","first-page":"2659","DOI":"10.1177\/0363546514545857","article-title":"Management of acute calcific tendinitis around the hip joint","volume":"42","author":"Park","year":"2014","journal-title":"Am J Sports Med"},{"key":"B11","doi-asserted-by":"publisher","first-page":"310","DOI":"10.1097\/00004728-199403000-00030","article-title":"Calcific tendinitis of the gluteus maximus tendon with cortical bone erosion: CT findings","volume":"18","author":"Mizutani","year":"1994","journal-title":"J Comput Assist Tomogr"},{"key":"B12","doi-asserted-by":"publisher","first-page":"65","DOI":"10.4103\/0971-9903.178111","article-title":"Calcific tendonitis of the gluteus maximus tendon: a case report and review of the literature","volume":"21","author":"Kumar","year":"2016","journal-title":"J Mahatma Gandhi Inst Med Sci"},{"key":"B13","doi-asserted-by":"publisher","first-page":"e997","DOI":"10.3928\/01477447-20160616-08","article-title":"Calcific tendinitis of the gluteus maximus in a golfer","volume":"39","author":"Williams","year":"2016","journal-title":"Orthopedics"},{"key":"B14","doi-asserted-by":"publisher","first-page":"E1561","DOI":"10.1503\/cmaj.171308","article-title":"Calcific tendinitis of the gluteus maximus of a 53-year-old woman","volume":"189","author":"Huang","year":"2017","journal-title":"CMAJ"},{"key":"B15","doi-asserted-by":"publisher","first-page":"3382","DOI":"10.1007\/s00167-020-06005-5","article-title":"Combining results from hip impingement and range of motion tests can increase diagnostic accuracy in patients with FAI syndrome","volume":"28","author":"P\u00e5lsson","year":"2020","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"B16","doi-asserted-by":"publisher","first-page":"479","DOI":"10.3399\/bjgp17X693041","article-title":"Greater trochanteric pain syndrome: a review of diagnosis and management in general practice","volume":"67","author":"Speers","year":"2017","journal-title":"Br J Gen Pract"},{"key":"B17","doi-asserted-by":"publisher","first-page":"1083","DOI":"10.2214\/AJR.12.10038","article-title":"Sonography of greater trochanteric pain syndrome and the rarity of primary bursitis","volume":"201","author":"Long","year":"2013","journal-title":"AJR Am J Roentgenol"},{"key":"B18","doi-asserted-by":"publisher","first-page":"4801474","DOI":"10.1155\/2016\/4801474","article-title":"Calcium apatite deposition disease: diagnosis and treatment","volume":"2016","author":"Beckmann","year":"2016","journal-title":"Radiol Res Pract"},{"key":"B19","doi-asserted-by":"publisher","first-page":"185","DOI":"10.3348\/jksr.2010.62.2.185","article-title":"External snapping hip syndrome: emphasis on the MR imaging features","volume":"62","author":"Choi","year":"2010","journal-title":"J Korean Soc Radiol"},{"key":"B20","doi-asserted-by":"publisher","first-page":"965","DOI":"10.2214\/ajr.181.4.1810965","article-title":"Osseous involvement in calcific tendinitis: a retrospective review of 50 cases","volume":"181","author":"Flemming","year":"2003","journal-title":"AJR Am J Roentgenol"},{"key":"B21","doi-asserted-by":"publisher","first-page":"168","DOI":"10.1016\/j.radcr.2016.11.009","article-title":"Bone scan findings in calcific tendinitis at the gluteus maximus insertion: some illustrative cases","volume":"12","author":"Van Damme","year":"2017","journal-title":"Radiol Case Rep"},{"key":"B22","doi-asserted-by":"publisher","first-page":"E4","DOI":"10.1053\/jars.2003.50021","article-title":"Endoscopic treatment of calcific tendinitis of gluteus medius and minimus","volume":"19","author":"Kandemir","year":"2003","journal-title":"Arthroscopy"},{"key":"B23","doi-asserted-by":"publisher","first-page":"368","DOI":"10.5535\/arm.2016.40.2.368","article-title":"Calcific tendinopathy of the gluteus medius mimicking lumbar radicular pain successfully treated with barbotage: a case report","volume":"40","author":"Jo","year":"2016","journal-title":"Ann Rehabil Med"},{"key":"B24","doi-asserted-by":"publisher","first-page":"917027","DOI":"10.3389\/fsurg.2022.917027","article-title":"Endoscopic treatment for calcific tendinitis of the gluteus medius: a case report and review","volume":"9","author":"Jian","year":"2022","journal-title":"Front Surg"},{"key":"B25","doi-asserted-by":"publisher","first-page":"e20.00974","DOI":"10.2106\/JBJS.CC.20.00974","article-title":"Endoscopic treatment of calcific tendinitis of the gluteus maximus: a case report","volume":"11","author":"Su","year":"2021","journal-title":"JBJS Case Connect"},{"key":"B26","doi-asserted-by":"publisher","first-page":"210","DOI":"10.5397\/cise.2020.00318","article-title":"Diagnosis and treatment of calcific tendinitis of the shoulder","volume":"23","author":"Kim","year":"2020","journal-title":"Clin Shoulder Elb"},{"key":"B27","doi-asserted-by":"publisher","first-page":"151","DOI":"10.1016\/j.jor.2024.05.023","article-title":"Effect of extracorporeal shock wave therapy and ultrasound-guided percutaneous lavage in reducing the pain of rotator cuff calcific tendinopathy; an updated systematic review and meta-analysis","volume":"56","author":"Forogh","year":"2024","journal-title":"J Orthop"}],"container-title":["Frontiers in Surgery"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2026.1805054\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T05:44:43Z","timestamp":1782452683000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2026.1805054\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,26]]},"references-count":27,"alternative-id":["10.3389\/fsurg.2026.1805054"],"URL":"https:\/\/doi.org\/10.3389\/fsurg.2026.1805054","relation":{},"ISSN":["2296-875X"],"issn-type":[{"value":"2296-875X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,26]]},"article-number":"1805054"}}