Muscle strain - anterior compartment muscles of thigh
An aspiring cross country runner comes with thigh pain, and clinical suspicion of quadriceps tendon rupture.
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The muscles of the anterior compartment of the left thigh namely vastus intermedius, vastus lateralis, rectus femoris and more prominently vastus medialis obliquus (VMO) show diffuse enlargement and edema with partial tearing of the medial and lateral distal aponeurosis. The medial patellofemoral ligament shows a low grade tear. the high signal in the VMO extends over a length of 16 cm in the craniocaudal plane. Also evident is minimal free fluid in the medial recess of suprapatellar pouch. This patient had findings at the right thigh too and he admitted to have run 18 km 3 days prior.
An ultrasound was performed and confirmed the normal configuration of the quadriceps tendon.
Muscle strains are acute injuries to the myofibril which causes tearing of muscle fibers either due to excessive stretching or overloading. Most muscle injuries in athletes are diagnosed clinically and treated conservatively. However MRI offers unparalleled resolution with accurate grading capabilities and high sensitivity for diagnosis of acute and chronic muscle injuries as well as tendinous ruptures.
- Chan O, Del Buono A, Best TM et-al. Acute muscle strain injuries: a proposed new classification system. Knee Surg Sports Traumatol Arthrosc. 2012;20 (11): 2356-62. doi:10.1007/s00167-012-2118-z - Pubmed citation
- Cross TM, Gibbs N, Houang MT et-al. Acute quadriceps muscle strains: magnetic resonance imaging features and prognosis. Am J Sports Med. 2004;32 (3): 710-9. Pubmed citation
- Shelly MJ, Hodnett PA, MacMahon PJ et-al. MR imaging of muscle injury. Magn Reson Imaging Clin N Am. 2009;17 (4): 757-73, vii. doi:10.1016/j.mric.2009.06.012 - Pubmed citation