Rectus femoris tendon avulsion in an amateur athlete: case report diagnosed by magnetic resonance
DOI:
https://doi.org/10.5433/1679-0367.2021v42n2p243Keywords:
Tendon injuries, Magnetic resonance imaging, Quadriceps muscle, ThighAbstract
Introduction: the rectus femoris muscle is the most frequently injured muscle of the quadriceps group during repetitive kicking and sprinting. Avulsions of the rectus femoris are rare injuries. Pain located at the proximal thigh and disability in flexing the hip and/or extending the knee associated with a patient history of a violent contraction or forceful stretching of the quadriceps femoris muscle group can indicate an avulsion of rectus femoris.Objective: report a case and review the literature about this uncommon lesion.
Materials and Methods: we reviewed medical records, photographic records of diagnostic methods, and reviews from the literature.
Results: a 46-year-old man with pain located at the left anterior hip with irradiation to the thigh for three months after falling to the ground with the sore region in a soccer game. The pain started suddenly one week after the fall. The MRI of the hip featured complete avulsion of the left rectus femoris, being 2 cm distal from the anterior inferior iliac spine with adjacent liquid effusion.
Conclusion: this report demonstrates the difficulty of diagnosing this lesion, since its physical examination is non-specific, and it can simulate more complex pathologies, requiring complementary tests for its correct diagnosis.
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References
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Brophy RH, Wright RW, powell JW, Matava MJ. Injuries to kickers in American football: the National Football League experience. Am J Sports Med. 2010;38(6):1166–73.
Dean CS, Arbeloa-Gutierrez L, Chahla J, Pascual-Garrido C. Proximal rectusfemorisavulsionrepair. Arthrosc Tech. 2016;5:e545–9.
Ekstrand J, Hagglund M, Walden M. Epidemiology of muscle injuries in professional football (soccer). Am J Sports Med. 2011 Jun;39(6):1226-32. doi: 10.1177/0363546510395879.
Ekstrand J, Hagglund M, Walden M. Injury incidence and injury patterns in professional football: the UEFA injury study. Br J Sports Med. 2011; 45(7):553–8.
Gamradt SC, Brophy RH, Barnes R, Warren RF, Thomas Byrd JW, Kelly BT. Nonoperative treatment for proximal avulsion of the rectus femoris in professional American football. Am J Sports Med. 2009;37(7):1370–74.
Garcia VV, Duhrkop DC, Seijas R, Ares O, Cugat R Surgical treatment of proximal ruptures of the rectus femoris in professional soccer players. ArchOrthop Trauma Surg. 2012 Mar;132(3):329-33. doi: 10.1007/s00402-011-1372-8.
Garcia VV, Duhrkop DC, Seijas R, Ares O, Cugat R. Surgical treatment of proximal ruptures of the rectus femoris in professional soccer players. ArchOrthop Trauma Surg2012;132(3):329–33
Garrett WE Jr. Muscle strain injuries. Am J Sports Med. 1996; 24[suppl 6]:S2–S8.
Gyftopoulos S, Rosenberg ZS, Schweitzer ME, Bordalo-Rodrigues M. Normal Anatomy and Strains of the Deep Musculotendinous Junction of the Proximal Rectus Femoris: MRI Features. AJR Am J Roentgenol. 2008 Mar;190(3):W182-6. doi: 10.2214/AJR.07.2947.
Hapa O, Bedi A, Gursan O, et al. Anatomic footprint of the direct head of the rectus femoris origin: cadaveric study and clinical series of hips after arthroscopic anterior inferior iliac spine/subspine decompression. Arthroscopy. 2013;29:1932–40.
Hasselmann CT, Best TM. An explanation for various rectus femoris strain injuries using previously undescribed muscle architecture. Am J Sports Med. 1995;23(4):493–9.
Hsu JC, Fischer DA, Wright RW.proximal rectus femoris avulsions in national football league kickers: a report of 2 cases. Am J Sports Med.2005;33(7):1085–7
Hughes C, Hasselman CT, Best, Martinez S, Garrett WE Jr. Incomplete, intrasubstance strain injuries of the rectus femoris muscle. Am J Sports Med 1995;23:500-6.
Hughes CT, Hasselman CT, Best TM, Martinez S, Garrett WE Jr. An explanation for various rectus femoris strain injuries using previously undescribed muscle architecture. Am J Sports Med 1995; 23:493–9.
Hughes CT, Hasselman CT, Best TM, Martinez S, Garrett WE Jr. Incomplete, intrasubstance strain injuries of the rectus femoris muscle. Am J Sports Med. 1995 Jul-Aug;23(4):500-6. doi: 10.1177/036354659502300422.
Irmola T, Heikkila JT, Orava S, Sarimo J. Total proximal tendon avulsion of the rectus femoris muscle. Scand J Med Sci Sports. 2007;17(4):378–82.
IrmolaT,HeikkiläJ T,OravaS,SarimoJ. total proximal tendon avulsion of the rectus femoris muscle. Scand J Med Sci Sports. 2007 Aug;17(4):378-82. doi: 10.1111/j.1600-0838.2006.00564.x.
Lasse Lempainen, JussiKosola, RicardPruna, JordiPuigdellivol, JuhaRanne, Sakari Orava. Operative Treatment of Proximal Rectus Femoris Injuries in Professional Soccer Players: A Series of 19 Cases. Orthop J Sports Med. 2018 Oct; 6(10)
Lempainen L, Kosola J, Pruna R, Puigdellivol J, Ranne J, Orava S. Operative treatment of proximal rectus femoris injuries in professional soccer players: a series of 19 cases. Orthop J Sports Med. 2018 Oct 2;6(10):2325967118798827.
Mendiguchia J, Alentorn-Geli E, Idoate F, Myer GD. Rectus femoris muscle injuries in football: a clinically relevant review of mechanisms of injury, risk factors and preventive strategies. Br J Sports Med. 2013;47(6):359–66.
Orchard JW. Intrinsic and extrinsic risk factors for muscle strains in australian football. Am J Sports Med 2001;29(3):292–7.
Ouellette H, Thomas BJ, Nelson E, Torriani M. MR imaging of rectus femoris origin injuries. Skeletal Radiol. 2006;35(9):665–72.
Ouellette H, Thomas BJ, Nelson E, Torriani M. MR Imaging of Rectus Femoris Origin Injuries. Skeletal Radiol. 2006 Sep;35(9):665-72. doi: 10.1007/s00256-006-0162-9.
Temple HT, Kuklo TR, Sweet DE, Gibbons CL, MurpheyetMD. Rectus femoris muscle tear appearing as a pseudotumor. Am J Sports Med1998 Jul-Aug;26(4):544-8. doi: 10.1177/03635465980260041301.
Ueblacker P, Müller-Wohlfahrt HW, Hinterwimmer S, Imhoff AB, Feucht MJ. Suture anchor repair of proximal rectus femoris avulsions in elite football players.Knee Surg Sports TraumatolArthrosc. 2015 Sep;23(9):2590-4. doi: 10.1007/s00167-014-3177-0.
Yildiz C, Aydin T, Yildiz Y, Kalyon TA, Basbozkurt M. Anterior inferior iliac spine apophyseal avulsion fracture. J South OrthopAssoc 2003: 12(1): 38–40.
Brophy RH, Wright RW, powell JW, Matava MJ. Injuries to kickers in American football: the National Football League experience. Am J Sports Med. 2010;38(6):1166–73.
Dean CS, Arbeloa-Gutierrez L, Chahla J, Pascual-Garrido C. Proximal rectusfemorisavulsionrepair. Arthrosc Tech. 2016;5:e545–9.
Ekstrand J, Hagglund M, Walden M. Epidemiology of muscle injuries in professional football (soccer). Am J Sports Med. 2011 Jun;39(6):1226-32. doi: 10.1177/0363546510395879.
Ekstrand J, Hagglund M, Walden M. Injury incidence and injury patterns in professional football: the UEFA injury study. Br J Sports Med. 2011; 45(7):553–8.
Gamradt SC, Brophy RH, Barnes R, Warren RF, Thomas Byrd JW, Kelly BT. Nonoperative treatment for proximal avulsion of the rectus femoris in professional American football. Am J Sports Med. 2009;37(7):1370–74.
Garcia VV, Duhrkop DC, Seijas R, Ares O, Cugat R Surgical treatment of proximal ruptures of the rectus femoris in professional soccer players. ArchOrthop Trauma Surg. 2012 Mar;132(3):329-33. doi: 10.1007/s00402-011-1372-8.
Garcia VV, Duhrkop DC, Seijas R, Ares O, Cugat R. Surgical treatment of proximal ruptures of the rectus femoris in professional soccer players. ArchOrthop Trauma Surg2012;132(3):329–33
Garrett WE Jr. Muscle strain injuries. Am J Sports Med. 1996; 24[suppl 6]:S2–S8.
Gyftopoulos S, Rosenberg ZS, Schweitzer ME, Bordalo-Rodrigues M. Normal Anatomy and Strains of the Deep Musculotendinous Junction of the Proximal Rectus Femoris: MRI Features. AJR Am J Roentgenol. 2008 Mar;190(3):W182-6. doi: 10.2214/AJR.07.2947.
Hapa O, Bedi A, Gursan O, et al. Anatomic footprint of the direct head of the rectus femoris origin: cadaveric study and clinical series of hips after arthroscopic anterior inferior iliac spine/subspine decompression. Arthroscopy. 2013;29:1932–40.
Hasselmann CT, Best TM. An explanation for various rectus femoris strain injuries using previously undescribed muscle architecture. Am J Sports Med. 1995;23(4):493–9.
Hsu JC, Fischer DA, Wright RW.proximal rectus femoris avulsions in national football league kickers: a report of 2 cases. Am J Sports Med.2005;33(7):1085–7
Hughes C, Hasselman CT, Best, Martinez S, Garrett WE Jr. Incomplete, intrasubstance strain injuries of the rectus femoris muscle. Am J Sports Med 1995;23:500-6.
Hughes CT, Hasselman CT, Best TM, Martinez S, Garrett WE Jr. An explanation for various rectus femoris strain injuries using previously undescribed muscle architecture. Am J Sports Med 1995; 23:493–9.
Hughes CT, Hasselman CT, Best TM, Martinez S, Garrett WE Jr. Incomplete, intrasubstance strain injuries of the rectus femoris muscle. Am J Sports Med. 1995 Jul-Aug;23(4):500-6. doi: 10.1177/036354659502300422.
Irmola T, Heikkila JT, Orava S, Sarimo J. Total proximal tendon avulsion of the rectus femoris muscle. Scand J Med Sci Sports. 2007;17(4):378–82.
IrmolaT,HeikkiläJ T,OravaS,SarimoJ. total proximal tendon avulsion of the rectus femoris muscle. Scand J Med Sci Sports. 2007 Aug;17(4):378-82. doi: 10.1111/j.1600-0838.2006.00564.x.
Lasse Lempainen, JussiKosola, RicardPruna, JordiPuigdellivol, JuhaRanne, Sakari Orava. Operative Treatment of Proximal Rectus Femoris Injuries in Professional Soccer Players: A Series of 19 Cases. Orthop J Sports Med. 2018 Oct; 6(10)
Lempainen L, Kosola J, Pruna R, Puigdellivol J, Ranne J, Orava S. Operative treatment of proximal rectus femoris injuries in professional soccer players: a series of 19 cases. Orthop J Sports Med. 2018 Oct 2;6(10):2325967118798827.
Mendiguchia J, Alentorn-Geli E, Idoate F, Myer GD. Rectus femoris muscle injuries in football: a clinically relevant review of mechanisms of injury, risk factors and preventive strategies. Br J Sports Med. 2013;47(6):359–66.
Orchard JW. Intrinsic and extrinsic risk factors for muscle strains in australian football. Am J Sports Med 2001;29(3):292–7.
Ouellette H, Thomas BJ, Nelson E, Torriani M. MR imaging of rectus femoris origin injuries. Skeletal Radiol. 2006;35(9):665–72.
Ouellette H, Thomas BJ, Nelson E, Torriani M. MR Imaging of Rectus Femoris Origin Injuries. Skeletal Radiol. 2006 Sep;35(9):665-72. doi: 10.1007/s00256-006-0162-9.
Temple HT, Kuklo TR, Sweet DE, Gibbons CL, MurpheyetMD. Rectus femoris muscle tear appearing as a pseudotumor. Am J Sports Med1998 Jul-Aug;26(4):544-8. doi: 10.1177/03635465980260041301.
Ueblacker P, Müller-Wohlfahrt HW, Hinterwimmer S, Imhoff AB, Feucht MJ. Suture anchor repair of proximal rectus femoris avulsions in elite football players.Knee Surg Sports TraumatolArthrosc. 2015 Sep;23(9):2590-4. doi: 10.1007/s00167-014-3177-0.
Yildiz C, Aydin T, Yildiz Y, Kalyon TA, Basbozkurt M. Anterior inferior iliac spine apophyseal avulsion fracture. J South OrthopAssoc 2003: 12(1): 38–40.
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2021-09-28
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Almeida TAF de, Braun MAA, Duarte ML, Santos LR dos, Silva M de QP da. Rectus femoris tendon avulsion in an amateur athlete: case report diagnosed by magnetic resonance. Semin. Cienc. Biol. Saude [Internet]. 2021 Sep. 28 [cited 2024 May 17];42(2):243-8. Available from: https://ojs.uel.br/revistas/uel/index.php/seminabio/article/view/39215
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