# The “Wave Sign” as Evidence of a “GUCCI” (Gluteal Undersurface Concealed Crescent Injury) Lesion: A Case Report

## TL;DR

A new hip injury called GUCCI was identified using a 'wave sign' during surgery in a patient with hip pain.

## Contribution

The 'wave sign' is introduced as a novel indicator of a concealed gluteal tendon injury during dynamic endoscopic examination.

## Key findings

- The 'wave sign' revealed a hidden GUCCI lesion during surgery despite intact superficial tendon fibers.
- Dynamic endoscopic examination is crucial for identifying concealed gluteal tendon injuries.
- Endoscopic repair was successfully performed for the identified GUCCI lesion.

## Abstract

A 63‐year‐old female presented with left lateral hip pain consistent with greater trochanteric pain syndrome (GTPS) and magnetic resonance imaging (MRI) findings of high‐grade gluteal tendinosis and partial tearing. She failed conservative management and was thus indicated for endoscopic greater trochanteric bursectomy and gluteal tendon repair. Intraoperatively, the superficial gluteus medius tendon fibers were intact, but a “wave sign” was present on dynamic examination. Subsequent investigation revealed a proposed GUCCI (gluteal undersurface concealed crescent injury) lesion, which underwent endoscopic repair. This case highlights the importance of dynamic endoscopic examination of the gluteal tendons, as identification of a trochanteric “wave sign” may reveal clinically significant pathology concealed beneath intact bursal‐sided fibers.