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Muscle strain - anterior compartment muscles of thigh

Case contributed by Nafisa Shakir Batta
Diagnosis almost certain

Presentation

An aspiring cross country runner comes with thigh pain, and clinical suspicion of quadriceps tendon rupture.

Patient Data

Age: 20 years
Gender: Male

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.

Normal configuration of the quadriceps tendon.

Case Discussion

Muscle strains are acute injuries to the myofibril which cause 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.

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