[MRI in musculoskeletal imaging: possibilities and limitations]

[Proximal avulsion of the rectus femoris muscle]

BACKGROUND

Injuries of the thigh muscles are among the most frequent sports injuries. For example, in soccer they represent nearly 30% of all injuries. The rectus femoris muscle is particularly exposed to injury due to its anatomical features. While distal ruptures involve the quadriceps tendon and are among the more frequent injuries not only in sports, proximal ruptures represent a rarity. Because of the mostly indifferent clinical signs, the diagnosis is often delayed. In the literature various versions of classifications on the grading of muscle injuries have been described.

OBJECTIVE

With respect to the rectus femoris muscle, there is no classification system from which a treatment decision or an algorithm can be derived. The problem is not only the unclear classification of the injury but also the variability of treatment options resulting from this.

MATERIAL AND METHODS

A selective search of the literature was carried out to construct a review article.

RESULTS

No standardized follow-up treatment after surgical interventions or an established procedure for conservative treatment is currently available.

CONCLUSION

The comparison of the individual studies is made difficult due to the low case numbers and nonuniform classification systems. A valid treatment algorithm can only be derived with difficulty based on the currently available data.

[Proximal avulsion of the tendon of the rectus femoris muscle : Case description and literature review]

Injuries of the thigh muscles are among the most common sports injuries. In soccer they represent nearly 30% of all injuries. The rectus femoris muscle in particular is often exposed to injuries due to its anatomical features. Versatile treatment strategies and posttreatment procedures are described in the literature, which take the type and duration of the injury and the physical constitution of the patient into consideration. This article presents the case of a 28-year-old hobby football player who suffered a proximal avulsion of a tendon of the rectus femoris muscle during a football match. After persistent complaints over 2 months operative treatment was performed by anchor refixation of the tendon. During the follow-up at 6 weeks postoperatively, there was a very good functional result with good mobility and only slightly reduced strength with early full load and movement. The anamnesis revealed no deficits in the side to side comparison 1.5 years after the trauma.

[Focused sonography in orthopedic emergencies]

Focused sonography of the musculoskeletal system in the emergency room should be done for time-effective and symptom-oriented detection of suspected findings. Analogous to other point-of-care ultrasound in emergency medicine, it is by definition not a complete ultrasound examination of the respective organ (e.g., shoulder, elbow). It allows detection of important findings (luxation, effusion, fracture or rupture) with good to excellent diagnostic accuracy. Afterwards computed tomography, magnetic resonance imaging or complete sonographic examination (according to the guidelines of the working group Bewegungsorgane der Deutschen Gesellschaft für Ultraschall in der Medizin, which are identical to those of the working group Orthopädie und Unfallchirurgie) should be added as clinically required. Sonography of the musculoskeletal system in the emergency room can be performed on the lying or sitting patient, except when examining the shoulder, in which there is a difference. The interventional procedures are safe, useful and time saving.