Indian Journal of Radiology and Imaging Indian Journal of Radiology and Imaging

MUSCULOSKELETAL
Year
: 2003  |  Volume : 13  |  Issue : 2  |  Page : 159--160

Rectus femoris compression type intrasubstance tear with chronic hematoma of the muscle belly


A Kharat, A Deo 
 Department of Radiodiagnosis Yeshwantrao Chavan Medical Hospital, Pimpri Chinchwad Municipal Corporation, Pimpri-18, India

Correspondence Address:
A Kharat
Flat No-2 Building No 34, Ranapur Darshan Society, New Alandi Road, Vishrantwadi, Yerawada, Pune 411006
India




How to cite this article:
Kharat A, Deo A. Rectus femoris compression type intrasubstance tear with chronic hematoma of the muscle belly.Indian J Radiol Imaging 2003;13:159-160


How to cite this URL:
Kharat A, Deo A. Rectus femoris compression type intrasubstance tear with chronic hematoma of the muscle belly. Indian J Radiol Imaging [serial online] 2003 [cited 2020 Sep 18 ];13:159-160
Available from: http://www.ijri.org/text.asp?2003/13/2/159/28652


Full Text

 Case Reports



A 22 year old college student a cycling enthusiast presented with pain and a nodular stony hard firm swelling in the middle of the anterior third of the right thigh since two months.

The pain started two months back after a period of excessive cycling during a cycling race event; this was followed by a slow growing lesion in the thigh which over a period of two months had become stony hard. Repeated radiographs were normal. Fat planes were maintained. No calcification was noted within the region. An ultrasound examination was done with a 3.5 MHz convex probe.

 Diagnosis



Rectus femoris compression type intrasubstance tear with chronic hematoma of the muscle belly.

 Discussion



The ultrasound examination reveals a well defined heterogeneous predominantly hypoechoic lesion within the substance of the right rectus femoris muscle. Few hyper echoic strands were noted within it which suggests a fibrous scar. The cystic spaces signify the presence of a seroma.

Tears are most commonly seen in the rectus femoris [1]. It is frequently torn in sports related activities. Tear are of two types:

Distraction tears result when a muscle is abruptly stretched to or above its maximum length.

Compression tears result when a great force is applied to a muscle externally, a crushing injury can occur, called compression tear[1]. Signs of complete rupture are discontinuity of the tendon or muscle.

The quadriceps commonly ruptures transversely at its insertion on the patella[2].

Healing of partial or complete tears may be seen in various stages.

Immediately after the tear the hematoma is hyper echoic.

Within 12 to 24 hours it starts organizing. In a few weeks it will organize with a seroma in the defect. Ultimate healing is with a fibrous scar which looks hyper echoic[1].

Surgically unrepaired hematomas develop ossifications seen as hyper reflective regions with posterior acoustic shadowing.

 Conclusion



Ultrasound in conjunction with the history and clinical examination can prove to be a simple, non invasive, cost effective, real time, dynamic and effective modality to assess muscle trauma and its various stages of healing.

References

1Nata Grobbelaar and J. Antonio Bouffard: Sonography of the Knee, A pictorial review. Seminars in ultrasound Ct and Mri. Vol 2 No 3, June 2000, pp244-245
2Phillip BB: Traumatic disorders, in Crenshaw AH (Ed): Campbell's Operative Orthopedics, Vol 3 (ed 8). St Louis, MO, Mosby-Year Book, 1992, PP 1895-1938