title: Imaging of rectus femoris proximal tendinopathies.
abstract: The rectus femoris is the most commonly injured muscle of the anterior thigh among athletes, especially soccer players. Although the injury pattern of the muscle belly is well documented, less is known about the anatomy and specific lesions of the proximal tendons. For each head, three distinctive patterns may be encountered according to the location of the injury, which can be at the enthesis, within the tendon, or at the musculotendinous junction. In children, injuries correspond most commonly to avulsion of the anteroinferior iliac spine from the direct head and can lead to subspine impingement. Calcific tendinitis and traumatic tears may be encountered in adults. Recent studies have shown that traumatic injuries of the indirect head may be underdiagnosed and that injuries of both heads may have a surgical issue. Finally, in the case of tears, functional outcome and treatment may vary if the rupture involves one or both tendons and if the tear is partial or complete. Thus, it is mandatory for the radiologist to know the different ultrasound and magnetic resonance imaging (MRI) patterns of these lesions in order to provide accurate diagnosis and treatment. The purpose of this article is to recall the anatomy of the two heads of rectus femoris, describe a reliable method of assessment with ultrasound and MRI and know the main injury patterns, through our own experience and literature review.
authors.affiliation: Centre d'Imagerie Ostéo-articulaire, Clinique du Sport de Bordeaux, 2, rue Georges Negrevergne, 33700, Mérignac, France. lionelpesquer@gmail.com.
authors.forename: Lionel
authors.initials: L
authors.lastname: Pesquer
authors.affiliation: Centre d'Imagerie Ostéo-articulaire, Clinique du Sport de Bordeaux, 2, rue Georges Negrevergne, 33700, Mérignac, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Poussange
authors.affiliation: Centre Orthopedique Santy, Groupe Ramsay Generale de Santé - Hôpital Privé Jean Mermoz, 24 avenue Paul Santy, Lyon, France.
authors.forename: Bertrand
authors.initials: B
authors.lastname: Sonnery-Cottet
authors.affiliation: Centre de Chirurgie Orthopédique et Sportive, Clinique du Sport de Bordeaux, 2, rue Georges Negrevergne, 33700, Mérignac, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Graveleau
authors.affiliation: Centre d'Imagerie Ostéo-articulaire, Clinique du Sport de Bordeaux, 2, rue Georges Negrevergne, 33700, Mérignac, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Meyer
authors.affiliation: Centre d'Imagerie Ostéo-articulaire, Clinique du Sport de Bordeaux, 2, rue Georges Negrevergne, 33700, Mérignac, France.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Dallaudiere
authors.affiliation: Centre d'Imagerie Ostéo-articulaire, Clinique du Sport de Bordeaux, 2, rue Georges Negrevergne, 33700, Mérignac, France.
authors.forename: Matthieu
authors.initials: M
authors.lastname: Feldis
mesh_terms: D006801:Humans; D008279:Magnetic Resonance Imaging; D052097:Quadriceps Muscle / Q000033:anatomy & histology / Q000000981:diagnostic imaging*; D052256:Tendinopathy / Q000000981:diagnostic imaging*; D013708:Tendon Injuries / Q000000981:diagnostic imaging; D013710:Tendons / Q000000981:diagnostic imaging*; D013848:Thigh; D014463:Ultrasonography
keywords: Anatomy; Magnetic resonance imaging; Rectus femoris; Tendon; Ultrasound