Idiopathic Fibrosis of the Quadriceps Muscle: A Case Report with Magnetic Resonance Imaging and Pathological Findings

* Department of Rehabilitation Medicine, Maharat Nakhon Ratchasima Hospital, Nakhon Ratchasima

Affiliation : Rachawan Suksathien MD*

Background : Idiopathic fibrosis of the quadriceps muscle can be defined as progressive loss of knee flexion due to fibrosis within the muscle developed in early childhood. A few cases have been reported, but these did not detail the MRI and pathological findings. Material and Method: A 28-year-old woman presented with difficulty in sitting and inability to bend both knees completely. The clinical evaluation, radiological examination, MRI, treatment and muscle pathology were demonstrated.
Results : The knee flexions were limited in both knee joints. Magnetic resonance imaging of both thighs showed marked quadriceps muscle atrophy with fat infiltration and fibrous band. Intraoperative findings demonstrated fibrous band of vastus intermedius and vastus lateralis muscles which correlated with the MRI. The histological findings also revealed loose connective tissue separating muscle fibers and large fibrous band. Z-plasty and release of the fibrotic muscles were performed. The result of the surgery was good.
Conclusion : This is the first report to correlate MRI and pathological findings of idiopathic fibrosis of the quadriceps muscle. Late diagnosis and treatment may produce irreversible changes of femoral condyles and patella. Clinical awareness with history, physical examination and radiographic findings which included MRI help in confirming the diagnosis and demonstrating the extent of fibrosis before surgery.

Keywords : Idiopathic fibrosis, Quadriceps contracture, Magnetic resonance imaging, Pathology

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