Updated: 10/6/2016

Rectus Femoris Strain

Topic
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Introduction
  • Due to overstretching the muscle which results in tearing of the muscle fibers of the rectus femoris
  • Epidemiology
    • seen more commonly in soccer and football players
  • Pathophysiology
    • mechanism
      • sudden, forceful eccentric contraction of the muscle
        • sprinting from standing position
        • kicking soccer ball with great force
    • pathoanatomy
      • acute injuries
        • usually more distal on the thigh
      • chronic injuries
        • usually occur closer to the muscle origin
  • Associated conditions
    • avulsion of anterior inferior iliac spine (AIIS) 
      • adolescent athletes may have proximal bony avulsion of anterior inferior iliac spine (AIIS) 
      • occurs at insertion site of direct head of rectus femoris  
Anatomy
  • Osteology
    • anterior inferior iliac spine (AIIS)  
      • origin of direct head of rectus femoris muscle
  • Muscles
    • rectus femoris 
      • crosses hip and knee joint
      • flexes hip and extends knee
Presentation
  • Symptoms
    • pain in the anterior aspect of the hip 
      • strain or avulsion at insertion on AIIS
    • pain midthigh
      • strain in muscle fibers
    • pain distally
      • most common finding
  • Physical exam
    • inspection and palpation
      • tenderness to palpation in the injured area
        • proximally at origin of rectus femoris muscle
        • muscle belly midthigh region
        • distally at knee
      • feel for defect in muscle indicating a full tear (unusual finding)
    • provocative maneuvers
      • pain elicited with resisted hip flexion or extension
Imaging
  • MRI
  • Ultrasound
  • Radiographs 
    • indications
      • concern for avulsion at insertion site on anterior inferior iliac spine in adolescent athletes 
    • findings
      •  normal in most cases
Treatment
  • Nonoperative
    • NSAIDS, rest, ice, stretching/strengthening
      • indications
        • definitive treatment for vast majority
      • outcomes
        • usually resolves within 4-6 weeks 
 

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Questions (3)
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(OBQ08.151) A teenage boy injured his hip while competing in a track meet. His radiograph is shown in Figure A. Which of the following muscles is most likely injured? Review Topic

QID: 537
FIGURES:
1

Tensor fascia lata

2%

(46/2342)

2

Gluteus medius

2%

(57/2342)

3

Gluteus minimus

1%

(21/2342)

4

Rectus femoris

93%

(2167/2342)

5

Biceps femoris

2%

(40/2342)

ML 1

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