MyPACS.net: Radiology Teaching Files > Case 332973

never visited RECTUS FEMORIS TEAR
Contributed by: Herman Wu, Radiologist, University of California, San Diego, California, USA.
Patient: 20 year old female
History: 20 year old soccer player with 6 months of left thigh anteromedial mass, increasing in size.
Images:[small]larger

Fig. 1: Figs 1-6: (non-sequential) axial T2 FSE with fat saturation images show focal intramuscular edema adjacent to the left rectus femoris tendon, as well as focal discontinuity of the tendon.

Fig. 2

Fig. 3

Fig. 4

Fig. 5

Fig. 6

Fig. 7: Axial T2 FSE with fat saturation more proximally also shows milder right rectus femoris edema, with an intact tendon.

Fig. 8: Corresponding coronal T2 FSE with fat saturation: the left rectus femoris tendon defect can be seen, as well as focal right rectus femoris muscle edema.

Fig. 9: Sagittal T2 FSE with fat saturation: again, there is focal left rectus femoris muscle edema.

Fig. 10
Discussion:

Muscle strains commonly present acutely after a discrete traumatic episode. However, one exception is the rectus femoris tear, which may present as a minimally tender palpable mass that mimics a soft tissue tumor. The injury may occur acutely and/or represent sequelae of chronic microtrauma.

The rectus femoris muscle is the most commonly injured component of the quadriceps muscle, due to its superficial position, as well as the fact that it traverses both the hip and the knee joints. The typical location for rectus femoris injury involves the distal interface with the quadriceps tendon. However, there is also a more proximal site of injury (seen in this case), located at the myotendinous junction of the deep tendon of the indirect head. The proximal tendon of the rectus femoris is composed of 2 parts: a superficial component arising from the direct head, as well as the aforementioned component arising from the indirect head.

References:

Hughes et al. Am J Sports Med 1995; 23(4): 500-506.
Hasselman et al. Am J Sports Med 1995; 23(4): 493-499.

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Additional Details:

Case Number: 332973Last Updated: 02-12-2004
Anatomy: Skeletal System   Pathology: Trauma
Modality: MRExam Date: 02-10-2004Access Level: Readable by all users

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