Vastus Lateralis Injury

about ultrasound and mri findings of vastus lateralis injury

 

This is the case of a young rugby player presenting an high degree strain of the vastus lateralis muscle at its proximal insertion, togheter with an aponeurotic fascial injury on the subcutaneous lateral side.

I always suggest to perform both the Mri and ultrasound investigations; with the Mri exam it is evident the bone marrow edema, due to the avulsion injury at the intertrochanteric line, suspected during the clinical evaluation but impossible to see on ultrasound exam.

Vastus Lateralis Injury

Coronal (left) and Sagittal (right) PD-Fs Mri scans (1.5 Tesla).

Vastus Lateralis Injury Axial Mri

Axial PD-Fs Mri scan (1.5 Tesla). The bone marrow edema and the avulsion injury are evident.

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Soleus Myotendinous Junction Injury

About aponeurotic medial insertion injury of the soleus muscle.

Knowing the anatomy and biomechanics of the gastrocnemius-soleus complex – or triceps surae – is crucial for an understanding of the etiology and treatment of all its possible injuries. Today I want to show you a painful partial lesion at the aponeurotic medial insertion of the soleus muscle in a professional soccer player.

One month after a soleus injury, a patient suffered for pain and discomfort at the distal soleus myotendinous junction; first examination was made with an ultraportable device directly on the pitch during a daily training session. A partial injury of the aponeurotic medial insertion was evident, togheter with muscle perilesional edema.

soleus-injury

Sagittal Ultrasound comparative examination of the medial soleus myotendinous junction; normal findings on the right side.

soleus-medial-insertion

Sagittal GeStir (left) and Coronal T2w Mri scans of the same patient (0.3 Tesla).

fse_t2__2__and_fse_t2__4_

Axial (left) and Sagittal (right) T2w Mri scans (0.3 Tesla).

With the dynamic ultrasound examination is better appreciated also an inflammation along the course of the posterior tibial nerve.

Also in this case the elastosonography evaluation works like a “contrast agent” well depicting the lesional area.

You can find further information about the complex anatomy of the triceps surae in this interesting scientific paper: Anatomy of the Triceps Surae: A Pictorial Essay