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# Superior gemellus

The superior gemellus is a small deep buttock muscle just above the obturator internus tendon; it turns the thigh outward.

Official name: Superior gemellus muscle

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## What it is

A small muscle running along the upper edge of the obturator internus tendon, from the ischial spine to the greater trochanter.

## What it does

Turns the thigh outward and holds the ball steady in the socket.

## Key points

- From top to bottom, the short lateral rotators are: piriformis, superior gemellus, [obturator internus](https://durgical.com/en/anatomy/obturator-internus/), [inferior gemellus](https://durgical.com/en/anatomy/inferior-gemellus-muscle/), [quadratus femoris](https://durgical.com/en/anatomy/quadratus-femoris-muscle/)
- Runs along the upper edge of the obturator internus tendon and blends with it; with the inferior gemellus they form the triceps coxae
- Arises from the outer surface of the ischial [spine](https://durgical.com/en/anatomy/region/spine/), the point that also anchors the [sacrospinous ligament](https://durgical.com/en/anatomy/sacrospinous-ligament/) and that the [pudendal nerve](https://durgical.com/en/anatomy/pudendal-nerve/) passes

## Key facts

**Origin**
Ischial spine

**Insertion**
Obturator internus tendon, to medial surface of greater trochanter

**Action**
Laterally rotates extended hip; abducts flexed hip; steadies femoral head

**Nerve**
Nerve to obturator internus (L5–S1) (some texts: L5–S2)

**Blood supply**
Inferior gluteal artery; [internal pudendal artery](https://durgical.com/en/anatomy/internal-pudendal-artery/)

## Relations

**Above**
[Piriformis](https://durgical.com/en/anatomy/piriformis-muscle/), with the [sciatic nerve](https://durgical.com/en/anatomy/sciatic-nerve/) and the inferior gluteal vessels emerging in the gap between them

**Below**
[Obturator internus tendon](https://durgical.com/en/anatomy/tendon-of-obturator-internus/), which it joins

**Superficial**
Sciatic nerve, then the [gluteus maximus](https://durgical.com/en/anatomy/gluteus-maximus-muscle/)

**Deep**
Posterior hip [joint capsule](https://durgical.com/en/anatomy/articular-capsule-of-knee-joint/) and the ischium

## How to find it

Not palpable. In the posterior approach to the hip it is seen as a thin band on the upper edge of the obturator internus tendon, just below the piriformis.

## On imaging

Too thin to judge alone; on axial MRI it is seen as part of the obturator internus tendon complex, just below the piriformis, on the back of the hip. After posterior hip replacement, MRI checks whether the short rotators were repaired or are torn and retracted. Oedema in the group appears in strains or ischiofemoral impingement. Radiographs and CT add little.

## Common problems

- Uncommonly, a source of deep buttock or pelvic pain when strained or tight.

## Clinical notes

- Detached with the obturator internus and the inferior gemellus in the posterior hip approach; repairing them reduces the risk of dislocation after hip replacement
- Deep gluteal syndrome: apart from classic piriformis syndrome, the sciatic nerve can be squeezed between the gemelli–obturator internus complex and the piriformis, causing buttock pain and sciatica-like symptoms

## Anatomical variants

- It may be doubled, and it can be absent, sometimes together with the inferior gemellus

## Related conditions

- [Piriformis syndrome](https://durgical.com/en/conditions/piriformis-syndrome/)

## Test yourself

Think of the answer, then tap the question to see it.

## What is the order of the short lateral rotators of the hip from top to bottom?

Piriformis, superior gemellus, obturator internus, inferior gemellus, quadratus femoris.

## Where does the superior gemellus arise, and which nerve supplies it?

From the ischial spine; supplied by the nerve to obturator internus (L5–S1).

## What is the triceps coxae?

The superior gemellus and inferior gemellus together with the obturator internus tendon they blend with.

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Educational information, not medical advice. For any symptom, see a health professional.

## Its names

**Official Latin (TA2)**
musculus gemellus superior TA2 2606

**Official Spanish (DeCS)**
Músculo gemelo superior

**English (TA2)**
Superior gemellus muscle

**Also called**
gemellus superior muscle · musculus gemellus spinalis

## Related

- [Piriformis](https://durgical.com/en/anatomy/piriformis-muscle/)
- [Obturator internus](https://durgical.com/en/anatomy/obturator-internus/)
- [Gluteal arteries](https://durgical.com/en/anatomy/superior-gluteal-artery/)
- [Femur](https://durgical.com/en/anatomy/femur/)
- [Hip bone](https://durgical.com/en/anatomy/hip-bone/)

Sources: Terminologia Anatomica (TA2); [Anatomy, Bony Pelvis and Lower Limb, Gemelli Muscles](https://www.ncbi.nlm.nih.gov/books/NBK557420/).

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Representative model, for educational purposes only.

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Source: https://durgical.com/en/anatomy/superior-gemellus-muscle/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/anatomy/superior-gemellus-muscle/