Rectus femoris muscle injury

Case contributed by Dr Maulik S Patel

Presentation

History of jerk / indirect injury to the anterior aspect of both thighs while cricket bowling about a week back. The right thigh was injured first followed by the left thigh. Complaining of bilateral anterior proximal - mid third of thigh pain.

Patient Data

Age: 15 years
Gender: Male
Ultrasound

RIGHT Rectus femoris                     

  • Direct head tendon               - intact
  • Indirect head tendon             - intact
  • Superficial aponeurosis         - intact
  • Central aponeurosis              - intact
  • Distal aponeurosis                - intact
  • There is an area of loss of normal muscle echo pattern involving outer muscle( direct head ). It Involves proximal mid third of thigh, away from the central aponeurosis. There are fluid clefts within it without encapsulated collection. It measures about 50 x 25 x 15 mm.
  • Other anterior muscles are normal.
  • There is no subcutaneous collection.

LEFT Rectus femoris                      

  • Direct head tendon               - intact
  • Indirect head tendon             - intact
  • Superficial aponeurosis         - intact
  • Central aponeurosis              - intact
  • Distal aponeurosis                - intact
  • There is an area of loss of normal muscle echo pattern involving outer muscle( direct head ). It involves proximal mid third of thigh, away from the central aponeurosis. There are fluid clefts within it without encapsulated collection. It measures about 55 x 25 x 15 mm.
  • Other anterior muscles are normal.
  • There is no subcutaneous collection.

Case Discussion

The rectus femoris muscle is one of the quadriceps muscles. It has muscle within muscle structure. The outer muscle originates from superficial aponeurosis which forms direct tendon. The inner muscle originates from central aponeurosis which forms indirect tendon. Superficial aponeurosis is aligned in the coronal plane. Central aponeurosis is a sagittally oriented band. Both muscle fibers insert into deep aponeurosis in the distal thigh. Rectus femoral is one the few muscles crossing two joints ( hip and knee joint in this case ). It is prone to injury in sports due to eccentric forces.

Ultrasound findings show grade I muscle injury involving outer muscle of bilateral rectus femoris in a cricket player.

 

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Case information

rID: 57153
Published: 15th Dec 2017
Last edited: 15th Dec 2017
Inclusion in quiz mode: Included

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