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Enthesitis of the direct tendon of the rectus femoris muscle in a professional volleyball player: A case report.

ABSTRACT: Enthesitis of the direct tendon of the rectus femoris muscle is a rare pathology which mainly affects professional athletes, and it is caused by overuse and repetitive microtrauma. Athletic jumping and kicking exert a great stress on the direct tendon of the rectus femoris muscle, and volleyball and football players are therefore most frequently affected. Enthesitis may occur suddenly causing pain and functional impairment possibly associated with partial or complete tendon injuries, or it may be a chronic condition causing non-specific clinical symptoms.We present the case of a professional volleyball player who felt a sudden pain in the left side of the groin area during a training session although she had suffered no accidental injury. The pain was associated with impaired ipsilateral limb function. Tendon rupture was suspected, and magnetic resonance imaging (MRI) was performed. MRI showed a lesion at the myotendinous junction associated with marked inhomogeneity of the direct tendon. Ultrasound (US) examination confirmed the presence of both lesions and allowed a more detailed study of the pathology.This is a typical case of enthesitis which confirms that MRI should be considered the examination of choice in hip pain, particularly when the patient is a professional athlete, thanks to its panoramic visualization. However, also US is an ideal imaging technique for evaluating tendon injuries thanks to its high spatial resolution, and it can therefore be used effectively as a second line of investigation.

SUBMITTER: Bortolotto C

PROVIDER: S-EPMC3558061 | biostudies-literature | 2011 Jun

REPOSITORIES: biostudies-literature

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Enthesitis of the direct tendon of the rectus femoris muscle in a professional volleyball player: A case report.

Bortolotto C C Coscia D R DR Ferrozzi G G

Journal of ultrasound 20110222 2

Enthesitis of the direct tendon of the rectus femoris muscle is a rare pathology which mainly affects professional athletes, and it is caused by overuse and repetitive microtrauma. Athletic jumping and kicking exert a great stress on the direct tendon of the rectus femoris muscle, and volleyball and football players are therefore most frequently affected. Enthesitis may occur suddenly causing pain and functional impairment possibly associated with partial or complete tendon injuries, or it may b ...[more]

PMID: 23396666

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Project description:BackgroundRectus femoris injuries are common among athletes, especially in kicking sports such as soccer; however, proximal rectus femoris avulsions in athletes are a relatively rare entity.Purpose/hypothesisThe purpose of this study was to describe and report the results of an original technique of surgical excision of the proximal tendon remnant followed by a muscular suture repair. Our hypothesis was that this technique limits the risk of recurrence in high-level athletes and allows for rapid recovery without loss of quadriceps strength.Study designCase series; Level of evidence, 4.MethodsOur retrospective series included 5 players aged 31.8 ± 3.9 years with acute proximal rectus femoris avulsion injuries who underwent a surgical resection of the proximal tendon between March 2012 and June 2014. Four of these players had recurrent rectus femoris injuries in the 9 months before surgery, while 1 player had surgery after a first injury. Mean follow-up was 18.2 ± 12.6 months, and minimum follow-up was 9 months. We analyzed the age, sex distribution, physical examination outcomes, type and mechanism of injury, diagnosis, treatment and complications during surgery, postoperative follow-up, and time to return to play. The Lower Extremity Functional Scale (LEFS) and Marx scores were obtained at 3-month follow-up, and isokinetic tests were performed before return to sports. A telephone interview was completed to determine the presence of recurrence at an average follow-up of 18.2 months.ResultsAt 3-month follow-up, all patients had Marx activity scores of 16 and LEFS scores of 80. Return to the previous level of play occurred at a mean of 15.8 ± 2.6 weeks after surgery, and none of the athletes suffered a recurrence. Isokinetic test results were comparable between both sides.ConclusionThe surgical treatment of proximal rectus femoris avulsions, consisting of resection of the tendinous part of the muscle, is a reliable and safe technique allowing a fast recovery in professional athletes.

Dataset Information

Enthesitis of the direct tendon of the rectus femoris muscle in a professional volleyball player: A case report.

Publications

Enthesitis of the direct tendon of the rectus femoris muscle in a professional volleyball player: A case report.

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