Some authors hypothesize that a trauma of the popliteomeniscal fascicles could lead to an unstable meniscus mimicking a Wrisberg variant, a so-called post-traumatic Wrisberg variant (61). Caranci F, Briganti F, La Porta M, Antinolfi G, Cesarano E, Fonio P, Brunese L, Coppolino F. Magnetic resonance imaging in brachial plexus injury. Popliteus tendon avulsion in the setting of multi-ligament tears. The popliteus tendon is part of the popliteus musculotendinous complex together with the popliteus muscle and the popliteofibular ligament and constitutes a part of the posterolateral corner of the knee. T1 (a) and STIR (b) axial sequences showing ill-defined mild TI hyperintensity of the popliteus muscle with subtle peripheral TI hypointensity representing the ossification seen on CT (arrow). Lee D-H, Kim T-H, Kim J-M, Bin S-I. 1). RadioGraphics. Diagnostic accuracy of ultrasound, conventional radiography and synovial fluid analysis in the diagnosis of calcium pyrophosphate dihydrate crystal deposition disease. sharing sensitive information, make sure youre on a federal Johnson RL, De Smet AA. Unable to process the form. Guney H, Kaya D, Yilgor C, Cilli M, Aritan S, Yuksel I, Doral MN. 8a-b). In case of PMFs tears, in symptomatic patients, surgery represents the treatment of choice (80). Mariani S, La Marra A, Arrigoni F, Necozione S, Splendiani A, Di Cesare E, Barile A, Masciocchi C. Dynamic measurement of patello-femoral joint alignment using weight-bearing magnetic resonance imaging (WB-MRI). Popliteus injuries are either sudden onset (acute) or gradual onset overuse injuries (chronic). 6), the myotendinous junction and the tendon itself (Fig. Musculoskeletal infection: role of CT in the emergency department. Figure 4: Normal anatomy and MRI appearance of the popliteus tendon. Early systemic sclerosis: analysis of the disease course in patients with marker autoantibody and/or capillaroscopic positivity. It is considered as an intracapsular but extrasynovial and extra-articular structure 4. Six weeks of conservative treatment provided a decrease in pain, but no neurological improvement.Electromyography indicated decreased nerve input activity of the FHL, TP and DFL muscles and decreased . Madani H., Farrant J., Chhaya N. Peripheral limb vascular malformations: an update of appropriate imaging and treatment options of a challenging condition. As said earlier, isolated injuries to popliteus muscle are rare and only 2 out of 2412 knee MRI studies showed isolated acute rupture of the popliteus tendon. The popliteus musculotendinous complex is a critical stabilizer of the posterolateral corner of the knee and resists both external rotation and posterior translation. Check for errors and try again. Deep chondral fissuring and associated subchondral reactive marrow change are additionally present at the lateral tibial plateau. 2018;89(1-S):7-17. They finally stated that a significantly high incidence of abnormal sPMFs was found not only in RSLM joint but also in contralateral knees (44). MRI scan or other radiography can be used to diagnose tendinopathy. Muscle tears are indirect muscle injury that occurs in eccentric . Cuomo G, Zappia M, Iudici M, Abignano G, Rotondo A, Valentini G. The origin of tendon friction rubs in patients with systemic sclerosis: a sonographic explanation. This recess extends from the popliteal hiatus along the proximal part of the popliteus tendon. Then it passes down and forms a muscle across the back of the knee to insert into the leg bone (tibia). Arthroscopic evaluation of the lateral compartment of knees with grade 3 posterolateral knee complex injuries. Osseous loose bodies from knee joint can track along the popliteus and so can PVNS. 5). Zappia M, Reginelli A, Chianca V et al. Accessibility Bencardino J.T., Rosenberg Z.S., Brown R.R., Hassankhani A., Lustrin E.S., Beltran J. Traumatic musculotendinous injuries of the knee: diagnosis with MR imaging. MR sagittal PDw fat sat sequence of normal postero-superior (arrowhead) and postero-inferior PMFs (arrow). 2021;80(3):505-13. Clinical History: An 84-year-old male presents with lateral knee pain and swelling. 1. . Pigmented villonodular synovitis: MRI characteristics. 6. Simonian PT, Sussmann PS, Wickiewicz TL, Potter HG, van Trommel M, Weiland-Holland S, Warren RF. Dubois J., Alison M. Vascular anomalies: what a radiologist needs to know. 8600 Rockville Pike The popliteus tendon is a common intra-articular location for gout in the knee. MRI is a well-established imaging technique in the musculoskeletal system and the frequency of recognition of normal PMF in the normal knees is high in almost all MRI studies (27, 31, 44-46). History of trauma and oedema of popliteus on MRI is strain and presence of peripheral rim of ossification in the muscle belly helps one to make the . Although a popliteo-meniscal fascicle tear often cause vague mechanical symptoms, their tears may be associated with a postero-lateral instability and/or knee snapping sensation due to subluxation of the lateral meniscus (63, 69, 76). An MRI scan was performed, and a complete tear of the popliteus tendon at its musculo-tendinous junction with retraction to the popliteus hiatus and associated oedema around the muscle belly was demonstrated on standard sagittal (Fig. The popliteusis the smallest and most superior muscle of the deep posterior compartment of the leg. Acute Calcific Tendinopathy of the Popliteus Tendon: A Rare Case Diagnosed Using a Multimodality Approach and Treated Conservatively. 1) and a bone contusion at the lateral femoral condyle. MRI of Popliteo-Meniscal Fasciculi of the Knee: A Pictorial Review. Less commonly, the tendinopathy may be secondary to non-traumatic causes, e.g. Axial CT(c) demonstrating peripheral ossification in the popliteus muscle. In this retrospective study we will review the anatomy of the popliteus and pathologies of the popliteus muscle and tendon, which include tears, infection, arteriovenous malformation, pigmented villonodular synovitis,. Some different treatments have been reported in literature: meniscectomy, coronary ligament and meniscocapsular repair, and thermal shrinkage of the posterolateral capsule (11, 44, 81). Development of the popliteomeniscal fasciculi in the fetal human knee joint. Magnetic resonance imaging in the evaluation of anatomical risk factors for pediatric obstructive sleep apnoea-hypopnoea: a pilot study. Correspondence: Marcello Zappia, MD, PhD, Department of Medicine and Health Science V. aDepartment of Musculoskeletal Radiology, Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, United Kingdom, bDepartment of Radiology, Peter MacCallum Cancer Centre, Melbourne, Australia. Popliteomeniscal fascicle tears. Diffusion tensor MRI to assess skeletal muscle disruption . Bethesda, MD 20894, Web Policies Ripani M, Continenza MA, Cacchio A, Barile A, Parisi A, De Paulis F. The ischiatic region: normal and MRI anatomy. Acyamella causing popliteal tendonitis. origin:lateral femoral condyle and posterior horn of lateral meniscus, insertion:posterior surface of proximal tibia at the medial 2/3rd aspect, just superior to the soleal line, stabilizes knee joint (resists lateral rotation of tibia on femur), unlocks knee joint (laterally rotates femur on fixed tibia), Please Note: You can also scroll through stacks with your mouse wheel or the keyboard arrow keys. Jo V.Y., Fletcher C.D. Axial T1 (a) and PDFS (b) demonstrating diffuse T1 mild hypointensity with diffuse STIR hyperintensity in the popliteus, tibialis anterior and proximal tibia. De Filippo M, Corsi A, Evaristi L, Bertoldi C, Sverzellati N, Averna R, Crotti P, Bini G, Tamburrini O, Zompatori M, Rossi C. Critical issues in radiology requests and reports. Pan W.R., Zeng F.Q., Wang D.G., Qiu Z.Q. Although subtle, a corresponding curvilinear fracture (arrow) is apparent on a frontal radiograph obtained a few days before the MRI. Become a Gold Supporter and see no third-party ads. Zappia M, Carfora M, Romano AM, Reginelli A, Brunese L, Rotondo A, Castagna A. Sonography of chondral print on humeral head. Congenital absence or isolated injuries of the PMFs can result in micro or gross instability of the meniscus producing snapping or locking of the knee (11-15); tear or insufficiency of PMFs associated with ACL tear increases the knee laxity in as many as 25% of patients. The majority of popliteus tears were involving the muscular or myotendinous portion; in this study 33/38: 86.8%, while only five cases had femoral tendon avulsion. It is a component of the posterolateral corner of the knee and acts as a major stabilizer of the posterolateral knee. Results of subtotal/total or partial meniscectomy for discoid lateral meniscus in children. Bernhardson AS, LaPrade RF. 1) and coronal/axial views (Fig. From its attachment at the posteromedial tibia the popliteus courses superolaterally. 4, Fig. Cappabianca S, Colella G, Russo A, Pezzullo M, Reginelli A, Iaselli F, Rotondo A. Maxillofacial fibrous dysplasia: personal experience with gadoliniumenhanced magnetic resonance imaging. Pinto F, Miele V, Scaglione M, Pinto A. Pain during this manoeuvre indicates injury to popliteus muscle. Bikkina RS, Tujo CA, Schraner AB, Major NM. For the popliteus muscle, some of these main symptoms that may be present in the event of a strain or tear: Pain in the back of the knee. Jadhav S, More S et al. The tendon of the popliteus passes through the popliteal hiatus, entering the knee joint and inserting into the lateral femoral condyle at the end of the popliteal sulcus. 2017;46(7):1003-6. MR sagittal proton density weighted with fat saturation (PDw fat sat) sequence (a) and arthroscopy (b) of normal popliteal hiatus with popliteal tendon (arrowheads) and antero-inferior PMF (arrows). MRI is a well-established imaging technique in the musculoskeletal system and the frequency of recognition of normal PMF in the normal knees is high in almost all MRI studies. Axial T1(a), STIR (b) and coronal STIR (c) demonstrating multiple loose bodies. Hayeri M.R., Ziai P., Shehata M.L., Teytelboym O.M., Huang B.K. Rarely, isolated tendinous avulsions of the popliteus may occur (Figure 9).1. 1 and 2) ().They serve as a primary restraint to external rotation and a secondary restraint to varus stress ().The complex itself consists of the popliteal tendon attachment on the popliteal sulcus of the lateral femoral condyle . Assessment of the popliteal hiatus on sagittal images is important as pathology such as meniscal flaps and loose bodies occasionally extend into this area (Figure 5). The popliteus muscle is located in the deep posterior compartment of the leg accompanied by three other muscles the flexor hallucis longus, flexor digitorum longus and tibialis posterior. When the popliteo-meniscal fascicles are disrupted, the normal peripheral hoop tension of the lateral meniscus is lost, and consequently the lateral meniscus could be displaced medially into the joint (78) (Fig. They occur gradually through overuse or may result from a sudden twisted knee, fall or collision. In fact the absence of PMF is often associate with normal C-shape morphology of meniscus (12, 59, 71) (Fig. In a case study, we found finding of an unusual amount of fluid related to the popliteus sheath but . For this reason if unstable condition of meniscus was suspected, arthroscopic observation with probing into the popliteo-meniscal fascicle area is essential for the identification of the fascicle tears. Klauser AS, Tagliafico A, Allen GM, Boutry N, Campbell R, Court-Payen M, Grainger A, Guerini H, McNally E, OConnor PJ, Ostlere S, Petroons P, Reijnierse M, Sconfienza LM, Silvestri E, Wilson DJ, Martinoli C. Clinical indications for musculoskeletal ultrasound: a Delphi-based consensus paper of the European Society of Musculoskeletal Radiology. It is in close relationship to the other posterolateral corner structures of the knee including lateral collateral ligament, arcuate and fabellofibular ligaments as well as the popliteofibular ligament for which the myotendinous junction of the popliteus muscle serves as a site of origin 1. Arthroscopy of the knee joint. The so called Wrisberg variant is the third of the three lateral meniscal variant described by Watanabe and Takeda in their classification and it is characterized by the absence of the PMFs as well as meniscotibial coronary ligament and the meniscofemoral ligament of Wrisberg or Humphrey represent as the only posterior stabilizing structure (59). Federal government websites often end in .gov or .mil. insertion: posterior surface of proximal tibia at the medial 2/3 rd aspect, just superior to the soleal line. The popliteofibular ligament (PFL) extends from the fibular styloid process to the popliteus tendon. Leal-Blanquet J, Gins-Cespedosa A, Monllau J. Bifurcated Popliteus Tendon: A Descriptive Arthroscopic Study. MRI readily delineates injuries of bone, other ligaments, menisci, cartilage, capsule, tendons, and vascular structures. Walczak B.E., Johnson C.N., Howe B.M. Terminology. Nurzynska D, DiMeglio F, Castaldo C, Latino F, Romano V, Miraglia R, Guerra G, Brunese L, Montagnani S. Flatfoot in children: Anatomy of decision making. MRI is more sensitive in identifying bone erosions than radiographs.21. Di Zazzo E, Porcile C, Bartollino S, Moncharmont B. For this reason if unstable condition of meniscus was suspected, arthroscopic observation with probing into the popliteo-meniscal fascicle area is essential for the identification of the fascicle tears (79). Case Report: A Hypermobile Wrisberg Variant Lateral Discoid Meniscus Seen on MRI. Learn about the Posterolateral Corner on MRI with focus to the popliteus muscle on with regards to anatomy, origin, insertions, and pathologies. Founder, MRI Online. 5. These injuries may occur in athletes . Received 2021 Jan 12; Revised 2021 May 22; Accepted 2021 May 23. Popliteus injuries can occur in isolation but are most frequently associated with other ligament injuries of the knee including 1-3,6:. Other tumours that can have associated calcification/ossification include synovial sarcoma, parosteal and soft tissue osteosarcoma, soft tissue chondrosarcoma, recurrent giant cell tumour, bizarre parosteal osteochondromatous proliferation (Nora's lesion) and bone sclerosing dysplasia such as melorheostosis.16. Axial(a) and coronal (b) STIR MR sequences demonstrating popliteus tendon tear (arrow) in the setting of multiple other injuries including cruciate ligament, lateral collateral ligament and posterolateral. 4A, 4B). Arthroscopy: The Journal of Arthroscopic & Related Surgery. Before its femoral insertion, it encircles the posterolateral portion of the lateral femoral condyle beneath the lateral collateral ligament of the knee 1-3. Before 5). Myositis ossificans. Tropical pyomyositis (myositis tropicans): current perspective. MR sagittal PDw fat sat sequences of postero-superior (arrow) and postero-inferior (arrowhead) PMFs tear. It forms the floor of the popliteus fossa. The popliteus muscle rotates the thigh outwards and 'unlocks' the knee when running. Bacterial osteomyelitis: findings on plain radiography, CT, MR, and scintigraphy. Tyler P., Saifuddin A. The popliteal hiatus is best evaluated in the sagittal plane (4C), as in this fat-suppressed proton-density-weighted image. The https:// ensures that you are connecting to the An official website of the United States government. The popliteo-meniscal fascicles are posterolateral meniscocapsular structures that from body and posterior horn of the lateral meniscus blend inferiorly into the popliteus musculotendinous unit and allow the tendon to pass from an intra-articular to an extra-articular compartment (20-25). ISBN:0702033944. Suganuma J, Inoue Y, Tani H, Sugiki T, Sassa T, Shibata R. Reconstruction of the Popliteomeniscal Fascicles for Treatment of Recurrent Subluxation of the Lateral Meniscus. Vascular malformation of popliteus though rare can be diagnosed by presence of vessels and intervening fat. Gout with involvement of the intra-articular popliteus as well as distal quadriceps tendons. 1a 1b 1c 1d Figure 1. The floating meniscus: MRI in knee trauma and implications for surgery. Isolated tears . Popliteomeniscal fasciculi and the unstable lateral meniscus: clinical correlation and magnetic resonance diagnosis. The entry point of the nerve into the popliteus muscle is the lateral distal margin inferior to the fibular head.4 The lymphatic drainage is to the popliteal nodes and subsequently to the deep inguinal nodes of the groin5. Mid-substance posterior cruciate ligament rupture and popliteus muscle partial tear. The .gov means its official. popliteus muscle and travel just posterior to the tibia (Fig. De Filippo M, Rovani C, Sudberry JJ, Rossi F, Pogliacomi F, Zompatori M. Magnetic resonance imaging comparison of intra-articular cavernous synovial hemangioma and cystic synovial hyperplasia of the knee. 9). Popliteus tendinopathy is a knee injury that typically occurs in combination with other traumatic injuries of the lateral knee, especially posterolateral corner structures, posterior cruciate ligament (PCL), and meniscus 1. 7). 2009;38(3):543-9. Your knee will feel tender when pressing in at the back. MR visualization of the popliteomeniscal fascicles. Axial T1(a) and STIR(b) demonstrating localised abscess formation in popliteus (arrow) and proximal tibia. This Web Clinic will delve into the anatomy and function of the popliteus tendon with case examples of both traumatic and chronic disease. Popliteus tendinosis results from chronic repetitive stress, may be seen with downhill runners and is characterized by tendon enlargement and intrasubstance intermediate signal. Abstract. Inclusion in an NLM database does not imply endorsement of, or agreement with, Rarely, hydroxyapatite deposition occurs at the popliteus tendon.4 Radiographs demonstrate a calcification or calcifications in the expected location of the popliteus tendon and if an MRI is obtained, associated edema and fluid should be noted. Pigmented villonodular synovitis. 3). 2008;33(6):1633-5. Fat-suppressed coronal (9A), sagittal (9B), and axial (9C) proton-density-weighted images of the knee demonstrate a tendon avulsion of the femoral attachment of the popliteus. Doucet C, Gotra A et al. The typical appearance is a synovial based mass with T1 intermediate to hypointense signal change. The joint effusion help to delineate the lesion of PMFs (white arrows) and lesion of popliteal musculotendinous junction (black arrow). Presentation with mono-articular involvement is the most common clinical scenario with the knee accounting for over 80% of cases.18 The diffuse type of disease tends to be more common in the larger joints.19 Presentation is often ambiguous and insidious but well documented features include slowly progressive pain, joint dysfunction, oedema, and soft tissue swelling.17 Recurrent joint haemarthrosis is a classically described presentation.20 PVNS in the popliteal hiatus and recess along with extension into the tendon sheath is well known and can present with lateral knee pain. 2. Ferrero G, Fabbro E, Orlandi D, Martini C, Lacelli F, Serafini G, Silvestri E, Sconfienza LM. As a library, NLM provides access to scientific literature. Folia Morphol. Fayad L.M., Carrino J.A., Fishman E.K. Despite many treatments have being proposed in literature since now there is high recurrence of knee locking after repair and it is fundamental to develop new surgical techniques in order to achieve better outcome. The popliteus tendon serves as an origin for the politeomeniscal fascicles. Two MR sagittal PDw fat sat consecutive sequences of Wrisberg variant of lateral meniscus with congenital absence of PMFs (with arrow) but normal C-morphology. Popliteus tendon rupture: a case report and review of the literature. ISBN:1451119453. Calf injuries are quite common amongst athletes and involve the gastrocnemius, soleus, popliteal, and plantaris muscles. Federal government websites often end in .gov or .mil. LaPrade RF. ADVERTISEMENT: Supporters see fewer/no ads. We describe the anatomy and various pathologies of the popliteus. Axial T1 & PDFS sequences demonstrating relatively homogenous TI iso to mild hyperintensity and PD hyperintensity with a lobulated margin following the course of the popliteus. Popliteus injuries can occur in isolation but are most frequently associated with other ligament injuries of the knee including 1-3,6:. 12, Fig. Overlying bursitis is additionally apparent. Churchill Livingstone. Gold R.H., Hawkins R.A., Katz R.D. MRI of the right knee revealed a split tear of the popliteus tendon at its attachment on the lateral femoral condyle (Fig. Incidence and MRI characterization of the spectrum of posterolateral corner injuries occurring in association with ACL rupture. Fat-suppressed coronal and axial proton-density-weighted images of the knee demonstrate a minimally displaced cortical avulsion (arrow) at the femoral attachment of the popliteus. and MRI of this region. The popliteus tendon is considered as intra-capsular . Clinical orthopaedics and related research. CME Eligible. Gray's Anatomy for Students: With STUDENT CONSULT Online Access, 3e. The popliteus musculotendinous complex functions as a static and dynamic restraint to external rotation especially on knee flexion and as a smaller stabilizer regarding internal rotation anterior translation and varus force 1,2. In complete LCL tears, there is a discontinuity of the fibers, and edema or hemorrhage of high signal intensity on fluid-sensitive MR images is detected at the tendon defect (Figs. Inclusion in an NLM database does not imply endorsement of, or agreement with, Salvati F, Rossi F, Limbucci N, Pistoia ML, Barile A, Masciocchi C. Mucoid metaplastic-degeneration of anterior cruciate ligament. The Posterolateral Corner Anatomy: Popliteus Muscle on MRI. In a study of traumatic injury by Brown etal. Learn about the Posterolateral Corner on MRI with focus to the popliteus muscle on with regards to anatomy, origin, insertions, and pathologies. However in literature there is still debate about the number of popliteomeniscal bands (26), most studies described at least two different fascicles: an antero-inferior and postero-superior (2, 27-30). The popliteus muscle is a small muscle on the posterolateral corner of the knee. George M, Wall EJ. This anatomic condition predisposes the posterior horn to hypermobility with locked or recurrent subluxation of lateral meniscus leading to knee locking or snapping in a young patient (61-64) (Fig. 1C). Yue BW, Gupta AK, Moorman CT, Garrett WE, Helms CA. Pyomyositis is a subacute infection, often referred to as a tropical myositis due to its penchant for warmer climes. 2017;46)7):1003-6. Zabrzyski J, Huri G, Yataganbaba A et al. Report of 52 cases surgically and histologically controlled. The popliteal recess is an extension of the synovial membrane of the knee joint. Accessibility Tears of PMFs could be an isolated consequence of trauma, but they have been observed at arthroscopic surgery in high percentage of knee injuries with anterior cruciate ligament tear and associated injuries of the postero-lateral complex (74, 75); the mechanisms of injury may involve a single traumatic event or subacute onset after repeated microtraumas (2). International Orthopaedics (SICOT). National Library of Medicine Jung H.C., Kim D.H., Park B.K., Park M.K. HFUS allows outstanding visualisation of superficial lesions whilst Doppler ultra-sonography is the most straightforward way to assess flow dynamics. In the second half of 1900's, some anatomic studies claim the important function of the PMF as stabilizers of the lateral meniscus; these anatomical . Avulsion fracture of the popliteus is extremely rare but easy to identify if present. A sagittal proton density-weighted image demonstrates a flap tear of the posterior horn of the lateral meniscus with a displaced meniscal flap (arrowhead) extending into the popliteal hiatus anterior to the popliteus tendon (arrow). Knee Case Review: Adult Male With a Meniscal Radial tear with a Pivot shift, Knee Case Review: Adult Female Chronic Meniscus Tear, Knee Case Review: Adult Male with a Pivot Shift Meniscus Root Injury, Chief Medical Officer, ProScan Imaging. FOIA 5).8,9 Popliteus injuries are detected in 1% of all knee MRI examinations.8. . Pigmented villonodular synovitis of synovial joints: clinical, pathologic, and radiologic features. Relationships Between the Joints of the Knee, The Basics of the Posterior Cruciate Ligament, Basic Anterior Cruciate Ligament (ACL) Anatomy, The Anatomy of the Anterior Cruciate Ligament Part 2, Anterior Cruciate Ligament Anatomy: Axial View, Anterior Cruciate Ligament Anatomy: Coronal View, Anterior Cruciate Ligament on MRI: Sagittal Views, Anterior Cruciate Ligament on MRI: Axial View, Anterior Cruciate Ligament on MRI: Coronal View, Medial Collateral Ligament Basics: Layer 1, Medial Collateral Ligament Basics: Layer 2 & 3, The Anatomy of the Lateral Collateral Ligament Complex - FCL, The Anatomy of the Lateral Collateral Ligament Complex (LCL) on MRI, The Anatomy of the Lateral Collateral Ligament Complex, The Anatomy of the Quadriceps Femoris Tendon of the Knee, MRI Anatomy of the knee: Quadricep Femoral Tendon, The Knee Anatomy: Posterior Medial Corner, The Posteromedial Corner: Semimembranosus Expansions, The Posteromedial Corner: Semimembranosus Expansions part 2, The Posteromedial Corner: Semimembranosus Expansions part 3, The Posteromedial Corner: Semimembranosus Expansions part 4, The Posteromedial Corner: Posterior Oblique Ligament, The Posteromedial Corner: Posterior Oblique Ligament part 2, The Posteromedial Corner: Oblique Popliteal Ligament, The Posteromedial Corner: Posterior Capsule, The Posterolateral Corner Anatomy: Introduction, The Posterolateral Corner Anatomy: Popliteus Muscle on MRI, The Posterolateral Corner: Arcuate and Fabellofibular Ligament, The Posterolateral Corner: Arcuate and Fabellofibular Ligament on MRI, The Posterolateral Corner Anatomy: Biceps Femoris Tendon, Knee Case Review: 14Yr old with Posterolateral Corner Football Injury, Case Review: 54 year old Male with a Twisting Injury, Case Review: 28 Year Old Football Player Who Heard a Pop While Making a Cut, Case Review: 90 Year Old Female Patient, No History of Trauma, Now Has Swelling, Case Review: Return to 14 Year Old Football Player Case, Case Review: 37 Year Old Male with Complex Knee Instability, Case Review: 28 Year Old Injured in a Fall, Case Review: PCL Injury Companion Discussion, Unknown Knee Case: 54yr Old Male With Knee Swelling, Case Review: 54 Year Old Male with injury and a small PCL, Case Review: 54 Year Old Male Assessing the Other Posterior Corner, Unknown Knee Case: 25yr Old involved in MVA, Case Review: 49 Year Old with Osteoarthritis, Case Review: 49 Year Old Female with Knee Pain and a Sensation of Catching, Case Review: 66 Year Old Female with Strange PCL Presentation, Case Review: 51 Year Old Male with Worsening Chronic Knee Pain, Case Review: 36 Year Old Female with Knee Locking after Kickball Game, Case Review: 23 Year Old Male with Pain After a Fall, Case Review: 22 Year Old Male with Knee Pain. Aspiration of the popliteus component cultured positive for staphylococcus aureus. Kaplan EB. Evaluate the TCO of your PACS download >, 750 Old Hickory Blvd, Suite 1-260Brentwood, TN 37027, Focus on Musculoskeletal and Neurological MRI, The Anterior Meniscofemoral Ligament of the Medial Meniscus. The PMFs have a crucial role as a stabilizers of the knee, avoiding the instability of the lateral meniscus during flexion and extension of the knee (11, 16, 37, 73). Miele V, Di Giampietro I, Ianniello S, Pinto F, Trinci M. Diagnostic imaging in pediatric polytrauma management. A tendon is a cord of tough tissue that connects muscles to bones. The posterolateral aspect of the knee: anatomy and surgical approach. It can broadly be divided into three categories including posttraumatic myositis ossificans that accounts for up to 75% of cases, non-traumatic/pseudomalignant myositis ossificans and the hereditary and pathologically diverse myositis ossificans progressive.13, Three overlapping stages of MO are described including early, intermediate and mature which also have differing radiological and clinical features. 2) (31). Errors in musculoskeletal MRI, Errors in Radiology. It has been denoted as the 5th ligament of the knee 3. Semitendinosus snapping: analysis of movement, electromyographic activities, muscle strength and endurance, motor control and joint position sense. The presence of an avulsed osteochondral fragment is favourable for subsequent surgical repair.12. 2. Displaced meniscal flap extending into the popliteal hiatus. Clinical investigation. [3, 9] to occur in association with acute anterior cruciate ligament tears in as many as 25% of patients. The popliteus tendon inserts onto the lateral femoral condyle within the anterior portion of the popliteal sulcus 1. The posterolateral corner of the knee: evaluation under microsurgical dissection. MR sagittal PDw fat sat sequence of acute tear of PMFs (arrow) with little antero-medial displacement of posterior horn of lateral meniscus (arrowhead). 2) (31, 42, 43). Rosas H. Unraveling the Posterolateral Corner of the Knee. LESSON 3, TOPIC 18. 10), this anatomic variant can have major clinical implications owing to accidental injury during surgery, which has been reported during meniscal re-pair [7], total knee arthroplasty [8, 9], and high tibial osteotomy [10, 11] (Fig. The presence of an avulsed osseous fragment should also be noted as these can be fixated back into place (Figure 8). In the second half of 1900s, some anatomic studies claim the important function of the PMF as stabilizers of the lateral meniscus; these anatomical structures work in conjunction with the popliteus musculotendinous unit to prevent excessive lateral meniscal movement and possible meniscus subluxation. Yu Chuah T., Loh T.P., Loi H.Y., Lee K.H. Lyle N, Sampson M, Barrett D. MRI of intermittent meniscal dislocation in the knee. Kimura M, Shirakura K, Hasegawa A, Kobayashi Y, Udagawa E. Anatomy and pathophysiology of the popliteal tendon area in the lateral meniscus: 2. Extensive intramuscular venous malformation in the lower extremity. Acute popliteus tendon tears typically occur in the setting of multi-ligament and meniscal tears and, as such, careful attention should be paid to the adjacent posterolateral corner structures as well as the cruciate ligaments and menisci1-3 (Figure 7). The Wrisberg variant of lateral meniscus is characterized by congenital absence of PMF fascicles and meniscotibial coronary ligament (12, 59, 60). MRI appearance of Wrisberg variant of discoid lateral meniscus. In the World Health Organization (WHO) classification it is classified as a member of the tenosynovial giant-cell tumours group of which there are two types with similar histological appearance including a localised or nodular form and a diffuse type also known as PVNS. 3, Fig. What is your diagnosis? Typically AVM's occur in the cutaneous and subcutaneous tissues however more complex lesions with intra-muscular, intra-articular and intra-osseous components are not uncommon and can create quite a diagnostic challenge. 3D render of the popliteus musculotendinous complex with the biceps femoris tendon (BT) partially removed demonstrates the popliteus tendon (PT) passing deep to the fibular collateral ligament (FCL) and inserting at the popliteal sulcus of the lateral femoral condyle. There was no injury to the . Isolated popliteus tendon avulsion. However, the presence of hemarthrosis, which is a common finding in patients with acute tears of the anterior cruciate ligament with particularly related risk of popliteo-meniscal fascicle tears, would be used as contrast media for better depict the anatomical structures (27) (Fig. Staubli HU, Birrer S. The popliteus tendon and its fascicles at the popliteal hiatus: gross anatomy and functional arthroscopic evaluation with and without anterior cruciate ligament deficiency. Lippincott Williams & Wilkins. The popliteus muscle-tendon unit forms robust attachments in the superior, inferior, medial, and lateral oblique aspects, highlighting its importance in posterolateral stability of the knee. Cappabianca S, Colella G, Pezzullo MG, Russo A, Iaselli F, Brunese L, Rotondo A. Lipomatous lesions of the head and neck region: Imaging findings in comparison with histological type. Multiple fat-suppressed axial (4A) and coronal (4B) proton-density-weighted images of the knee from inferior to superior and posterior to anterior, respectively, demonstrate the superolateral ascension of the popliteus muscle (asterisk) and extra-articular and intra-articular tendon (arrow), deep to the fibular collateral . Routine assessment of the tendon and its hiatus in all imaging planes should be performed to ensure that relevant pathology is not overlooked. official website and that any information you provide is encrypted Miele V, Di Giampietro I. Note the PMFs torn (arrow). MRI. The Munich consensus statement (expert level evidence) states muscle tear is the preferred term denoting "structural injuries of muscle fibers/bundles leading to loss of continuity and contractile properties" 1.. It is unique, inverted, having insertion with a proximal tendinous origin from the lateral condyle of the femur and a distal muscular insertion onto the posterior aspect of the proximal tibia (Fig. Reference article, Radiopaedia.org (Accessed on 05 Jun 2023) https://doi.org/10.53347/rID-44427, Figure 1: knee ligaments (Gray's illustrations), see full revision history and disclosures, posterior suprapatellar (prefemoral or supratrochlear) fat pad, anterior suprapatellar (quadriceps) fat pad, accessory anterior inferior tibiofibular ligament, superficial posterior tibiotalar ligament, superficial posterior compartment of the leg (calf), accessory extensor digiti secundus muscle, descending branch of the lateral circumflex. Shittu A., Deinhardt-Emmer S., Vas Nunes J., Niemann S., Grobusch M.P., Schaumburg F. Tropical pyomyositis: an update. Masciocchi C, Conti L, DOrazio F, Conchiglia A, Lanni G, Barile A. The muscle inserts into a triangular area along the posteromedial aspect of the proximal tibial metaphysic above the soleal line. Cortical avulsion at the femoral attachment of the popliteus tendon. calcific tendinitis 2 or rarely present as . Garner H.W., Ortiguera C.J., Nakhleh R.E. Masciocchi C, Lanni G, Conti L, Conchiglia A, Fascetti E, Flamini S, Coletti G, Barile A. Soft-tissue inflammatory myofibroblastic tumors (IMTs) of the limbs: Potential and limits of diagnostic imaging. Noonan T.J., Garrett W.E., Jr. Vinson E, Major N et al. (www.actabiomedica.it). Associations. However patients with no significant history can also be affected, and there is a higher incidence among children and young adults.23 The lower limbs tend to be the most commonly affected especially the thigh musculature and in particular the quadriceps, followed by the psoas and gluteal muscles.24 No case of pyomyositis of popliteus has been reported in literature. 14). Careers, Unable to load your collection due to an error. Injuries at the myotendinous junction. Guha A.R., Gorgees K.A., Walker D.I. The https:// ensures that you are connecting to the As a library, NLM provides access to scientific literature. Myositis ossificans of popliteus muscle is extremely rare and we could not find any reported case in literature. Aliprandi A, Sconfienza LM, Randelli P, Bandirali M, Tritella S, Di Leo G, Sardanelli F. Magnetic resonance imaging of the knee after medial unicompartmental arthroplasty. This intra-articular tear is amenable to arthroscopic repair. Park JH, Ro KH, Lee DH. Garofalo R, Kombot C, Borens O, Djahangiri A, Mouhsine E. Locking knee caused by subluxation of the posterior horn of the lateral meniscus. The popliteus tendon starts outside the knee, attaching to the thigh bone (femur) and the lateral meniscus. It is likely due to long standing high pressure in the vascular malformation eroding causing pressure induced bony erosion. The radiological differential includes amyloid arthropathy, haemophila associated arthropathy, and synovial chondromatosis. It is important to differentiate this snapping cause from the others one, like subluxations of the biceps femoris (65), discoid lateral meniscus (66), popliteus (67) and semitendinosus snapping (68). An MRI showed that the popliteus muscle had ruptured with a hematoma in the upper calf fibres, causing pressure against the neurovascular bundle. The findings in (10a-12a) indicate a combined PCL injury with associated injury of the posterolateral corner. Careers, Unable to load your collection due to an error. Hemosiderin deposition in the synovium leads to shortening of T2 relaxation times and characteristic T2 hypointensity(Fig. Despite many treatments have being proposed in literature since now there is high recurrence of knee locking after repair and it is fundamental to develop new surgical techniques in order to achieve better outcome. Popliteomeniscal fascicles: anatomic considerations using MR arthrography in cadavers. The imaging of myositis ossificans. The remainder of the posterolateral structures, cruciate ligaments, medial collateral ligament and menisci are intact in this patient. It is important to be aware of the normal magnetic resonance (MR) imaging appearance of the popliteus musculotendinous complex and its relation to other structures of the posterolateral corner for accurate . Axial (a) and coronal (b) CT arthrogram demonstrating the popliteus tendon (arrow) located in the popliteal groove of the lateral femoral condyle. However, 11% to 33% of patients who undergo coronary ligament and meniscocapsular repair or RFE of the posterolateral capsule have high recurrence of knee locking, whereby new surgical techniques are being developed in recent years (76, 82). Sussmann et al. Normal anatomy and MRI appearance of the popliteus tendon. Popliteomeniscal Fascicle Tears Causing Symptomatic Lateral Compartment Knee Pain Diagnosis by the Figure-4 Test and Treatment by Open Repair. Acta radiologica (Stockholm, Sweden: 1987). What are the findings? The .gov means its official. When present the cyamella can articulate with the lateral condyle of the tibia.6, Injury to the popliteus musculotendinous complex is relatively common and most often occurs in combination with other injuries particularly to but not limited to the other structures of the posterolateral corner of the knee.7 In addition cruciate, collateral ligament injuries and meniscal tears can be associated with popliteus injury (Fig. The popliteus is a thin and flat muscle that forms part of the floor of the popliteal space. MR imaging of atraumatic muscle disorders. 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