Presentation
c/o pain lateral aspect of thigh x 2 weeks. No history of trauma.
Patient Data
X-ray AP view of pelvis:
Mild degenerative changes of hip & SI joints.
No evidence of cortical break.
Normal alignment of hip joints.
The hip joints show normal alignment.
Both hip and sacroiliac joints show mild degenerative changes.
Mild superolateral labral degeneration with subchondral cystic changes of adjacent acetabular margin noted in right hip joint.
Mild thickening and increased signal of indirect head of right rectus femoris muscle, near its origin at supra-acetabular ridge – suggestive of partial strain.
Mild left gluteus medius tendinosis, with adjacent greater trochanteric bursitis.
Mild synovial effusion noted in both hip joints (R>L).
Case Discussion
Rectus femoris forms part of the quadriceps group of muscles with joint insertion into patella.
It has two tendinous origins:
Direct head - from the anterior inferior iliac spine.
Indirect head - from supraacetabular ridge & adjacent joint capsule.
Injuries to direct head with avulsion fracture of AIIS is common in young athletes.
However rarely, injury to deep head can occur in older individuals contributing to lateral thigh pain.