An anatomical study of the indirect tendon of the rectus femoris using ultrasonography.

Abstract

The aim of this study was to demonstrate that ultrasound can allow a precise assessment of the indirect tendon of the rectus femoris using a new lateral approach. Four hips were dissected for the anatomical study of the proximal rectus femoris insertions. Under ultrasonographic guidance, spinal needles piercing the direct tendon were placed in the indirect tendon, following by dissection. Then, high-resolution ultrasound was performed in 20 volunteers with assessment of the indirect tendon of the rectus femoris. At dissection, the spinal needles were located in or immediately adjacent to the indirect tendon, thus confirming that it was correctly depicted by ultrasound. The indirect tendon could be identified in each cadaver and each volunteer with ultrasound. The optimal position of the probe to allow assessment of the indirect tendon could be defined. No significant changes in the appearance or thickness of the tendon could be observed. The results of our study showed that the indirect tendon of the rectus femoris muscle can be clearly depicted by sonography in healthy adult subjects. The potential applications of this new use of sonography must now be confirmed by clinical studies. • The anatomy of the proximal rectus femoris is reviewed • Until now, sonography was limited for assessing direct and conjoined tendons • The indirect tendon can be clearly depicted by sonography • A new lateral approach for studying the indirect tendon is described.