|ESSR 2019 / P-0130|
|Layered Anatomic Approach: The Quadriceps Muscle Complex Injuries|
•MRI can identify direct and indirect tendon origins.
•Most intramuscular injuries of RF involve deep myotendinous junction.
•Eccentric contraction, hip extension & knee flexion.
A 18-year-old manhad a complete grade III proximal direct and indirect proximal rectusfemoriswithanintact ASIS membrane.The ASIS membrane constraintstheRectusFemorismuscle at itstheoreticalanatomic position tetheringthedirect and indirect tendonstumps
A similar concept to the ASIS –RF membrane , has been evolving at the elbow where nowadays it is accepted that the insertion of the distal biceps has evolved to “the distal biceps brachii tendinous complex “ formed by the internal bicipital aponeurosis, the distal biceps brachii tendon and the external bicipital aponeurosis (also known as lacertus fibrosus).Our research supports a novel anatomic approach
There is an additional membranous fan-shaped origin ,a frequent anatomic variant , from ASIS
The ASIS origin implies to evolve from classic RF direct and indirect tendon origin to the
“ PROXIMAL RF TENDINOMEMBRANOUS COMPLEX “
Additional membranous fan-shaped origin running from the proximal membranous origin continuation from anterosuperior iliac spine ASIS is a frequent anatomic variant.
èThe tensor vastus intermedius muscle (TVI) fulfils all criteria for an independent muscle. It is innervated by independent branches of the femoral nerve and is vascularized through separate muscle branches èInterpreting the TVI as an independent muscle and understanding its role within the extensor mechanism would change our understanding of the complex architecture and function of the extensor apparatus of the knee joint as a whole
QMC myomyouspointoffailureresearch : intramuscular deglovingrectusfemoris injuryphenomenonpathogenesis
•Role of unipennate outer muscle versus bipennate inner muscle with central tendon is under research •Role of central aponeurosis /COMPLEX aponeurotic system is under research
•Genus Articularis muscle ( GA ) is a vestigial muscle deep to quadriceps on the anterior aspect of the thigh that consists of several bundles which arise from the distal third surfaces of the femur . •A similar concept to genus articularis-vastus intermedius complex has been evolving at the elbow where it has resemblance to “ elbow´s subanconeus-medial head of the triceps concept” (Subanconeus is a muscle also controversial about if it is an independent muscle and also has de capsular insertions) . •Articularis genus is a deep bundle of quadriceps femoris related to vastus intermedius or an and its distal capsular insertions Subaconeus area considered to represent the deep fibres of the medial head of triceps brachii and genus articularisis considered by some authors to represent the deep fibres of vastus intermedius as both share a common innervation from branches of the femoral nerve •From the clinical point of view it has been observed that participates in the elevation of the suprapatellar bursa on stimulating a branch of the femoral nerve and contribute to retract the suprapatellar bursa proximally has a protective role preventing interposition of these structures between the patella and femur during maximal extension of the knee joint •Further research is required to evaluate if the genus articularis-vastus intermedius complex dysfunction is related undifferentiated anterior knee pain manifested by fat pad edema on MRI
DISTAL RECTUS FEMORIS TENDINOUS INSERTION COMPLEX CONCEPT
The “prepatellar quadriceps continuation” is the appropriate designation
for the deepest soft-tissue layer that lies anterior to the patella, related to the deep rectus femoris tendinous fibers
The prepatellar quadriceps continuation is formed by fibers of the rectus femoris tendon and connects the quadriceps and patellar tendons.
The attachment site of the prepatellar quadriceps continuation is formed by the distal extension of the deep longitudinal fibers of the rectus femoris tendon. At the border zone between the tendons and the patella, the tendinous fibers gradually transform into fibrocartilage.
Thematically related posters
ESSR 2019 / P-0115
Migratory loose bodies from the ankle joint to the flexor hallucis longus tendon sheath – Imaging features