Nozawa Satoshi, Tanaka Chiaki, Shikata Jitsuhiko, Yamamuro Takao
Department of Orthopaedic Surgery, Kyoto City Hospital, Kyoto, Japan.
Arch Orthop Trauma Surg. 2004 May;124(4):272-4. doi: 10.1007/s00402-003-0590-0. Epub 2003 Oct 8.
Case report of a rare form of congenital contracture of the quadriceps muscle. Congenital contracture of the quadriceps muscle is encountered very rarely in daily orthopaedic practice. A few cases have been reported, but unfortunately these did not detail the MRI findings of congenital contracture.
A 34-year-old woman presented with difficulty in sitting with full flexion of the bilateral knee joints. She had no history of intramuscular injection, and her brother had a similar abnormality. A physical and radiographical review of the case was conducted.
A palpable corded induration was detected in the quadriceps muscle which prevented further flexion of the bilateral knee joints. Magnetic resonance imaging of both thighs demonstrated marked atrophy of the rectus femoris muscle and dark signal intensity of the muscle on both T1-weighted and T2-weighted images. It was suggested that the muscles had been replaced by fibrosis.
This appears to be the first report to include MRI findings of congenital contracture. Clinical awareness of congenital contracture with unique clinical symptoms and radiographic findings may aid the correct diagnosis.
股四头肌先天性挛缩罕见病例报告。在日常骨科实践中，股四头肌先天性挛缩极为罕见。虽有少数病例报告，但遗憾的是这些报告未详细描述先天性挛缩的磁共振成像（MRI）表现。
一名34岁女性因双侧膝关节完全屈曲时坐位困难前来就诊。她无肌肉注射史，其兄弟有类似异常情况。对该病例进行了体格检查和影像学检查。
在股四头肌处可触及条索状硬结，这阻碍了双侧膝关节的进一步屈曲。双侧大腿的磁共振成像显示股直肌明显萎缩，在T1加权像和T2加权像上肌肉均呈低信号强度。提示肌肉已被纤维组织替代。
这似乎是首份包含先天性挛缩MRI表现的报告。对具有独特临床症状和影像学表现的先天性挛缩提高临床认识，可能有助于正确诊断。
