title: Proximal Rectus Femoris Avulsion: Ultrasonic Diagnosis and Nonoperative Management.
abstract: OBJECTIVE
  To present a case of ultrasonic diagnosis and nonoperative management of a complete proximal rectus femoris avulsion in a National Collegiate Athletic Association Division 1 soccer goalkeeper.
  
  
  BACKGROUND
  While delivering a goal kick, a previously uninjured 24-year-old collegiate soccer goalkeeper had the sudden onset of right anterior thigh pain. He underwent rehabilitation with rapid resolution of his presenting pain but frequent intermittent recurrence of anterior thigh pain. After he was provided a definitive diagnosis with musculoskeletal ultrasound, he underwent an extended period of rehabilitation and eventually experienced complete recovery without recurrence.
  
  
  METHODS
  Rectus femoris avulsion, rectus femoris strain or partial tear, inguinal hernia, or acetabular labral tear.
  
  
  METHODS
  Operative and nonoperative options were discussed. In view of the player's recovery, nonoperative options were pursued with a good result.
  
  
  RESULTS
  Complete proximal rectus femoris avulsions are rare. Our case contributes to the debate on whether elite-level kicking and running athletes can return to full on-field performance without surgery.
  
  
  CONCLUSIONS
  Complete proximal rectus femoris avulsions can be treated effectively using nonoperative measures with good preservation of function even in the elite-level athlete. In addition, musculoskeletal ultrasound is an excellent tool for on-site evaluation and may help guide prognosis and management.
authors.affiliation: Southeast Orthopedic Specialists, Ponte Vedra Beach, FL;
authors.forename: Stephan
authors.initials: S
authors.lastname: Esser
authors.affiliation: Warner University, Lake Wales, FL;
authors.forename: David
authors.initials: D
authors.lastname: Jantz
authors.affiliation: Department of Family and Sports Medicine, Mayo Clinic, Jacksonville, FL.
authors.forename: Mark F
authors.initials: MF
authors.lastname: Hurdle
authors.affiliation: Department of Family and Sports Medicine, Mayo Clinic, Jacksonville, FL.
authors.forename: Walter
authors.initials: W
authors.lastname: Taylor
mesh_terms: D000328:Adult; D001265:Athletic Injuries / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000534:rehabilitation; D002358:Cartilage, Articular / Q000293:injuries; D006801:Humans; D008297:Male; D059352:Musculoskeletal Pain / Q000209:etiology; D052097:Quadriceps Muscle / Q000000981:diagnostic imaging / Q000293:injuries*; D012008:Recurrence; D012420:Running / Q000293:injuries; D012916:Soccer / Q000293:injuries*; D013180:Sprains and Strains / Q000000981:diagnostic imaging* / Q000534:rehabilitation; D013708:Tendon Injuries / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000534:rehabilitation; D014463:Ultrasonography
keywords: athletic injuries; rehabilitation; soccer