Final diagnosis made of calcific tendonitis in the direct tendon of the rectus femoris muscle.
Initially, he did start conservative treatment with NSAIDs, physical therapy, and rest with poor clinical response for the duration of one week. Then, the decision was made to proceed with corticosteroid injection of the rectus femoris tendon sheath under ultrasound guidance using 3 mL 1% Lidocaine and 12 mg Celestone with needling technique of the ossification.
The patient had complete resolution of symptoms with full return to play within one week of activity progression. He had no symptoms for the reminder of the season.
The case study demonstrates the value of MSK US in the treatment of this uncommon injury.
1. Bortolotto, C. et al. Enthesitis of the Direct Tendon of the Rectus Femoris Muscle in a Professional Volleyball Player: A Case Report. Journal of Ultrasound (2011) 14, 95-98.
2. Hong, Myong Joo et al. Successful Treatment of Rectus Femoris Calcification with Ultrasound-Guided Injection: A Case Report. The Korean Journal of Pain (2015) Vol. 28, No. 1: 52-56.
3. Zini, Raul et al. Rectus Femoris Tendon Calcification: Arthroscopic Excision in 6 Top Amateur Athletes. The Orthopaedic Journal of Sports Medicine (2014), 2 (12), 1-6.
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