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Posteromedial knee friction syndrome: an entity with medial knee pain and edema between the femoral condyle, sartorius and gracilis

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Abstract

Objective

To describe MRI features of an entity consisting of medial knee pain and edema between the posteromedial femoral condyle (PMFC), sartorius and/or gracilis tendons and determine whether reduced tendon-bone distances may account for these findings.

Methods

We retrospectively identified MRI cases of edema between the PMFC, sartorius and/or gracilis tendons (25 subjects, 26 knees). Two musculoskeletal radiologists independently graded edema and measured the sartorius- and gracilis-PMFC distances and knee flexion angle. Age- and gender-matched subjects with normal knee MRIs (27 subjects, 27 knees) served as controls for measurements. Statistical analyses compared abnormal to control subjects.

Results

Sartorius-PMFC and gracilis-PMFC spaces were narrower in abnormal compared to control subjects (1.6 ± 1.0 vs. 2.1 ± 1.2 mm, P = 0.04; 2.3 ± 2.0 vs. 4.6 ± 3.0 mm, P = 0.002, respectively). The knee flexion angle was similar between groups (P > 0.05). In subjects with clinical information, medial knee pain was the main complaint in 58 % (15/26) of abnormal subjects, with 42 % (11/26) having clinical suspicion of medial meniscal tear. Edema between the PMFC, sartorius and/or gracilis was mild in 54 % (14/26), moderate in 35 % (9/26) and severe in 12 % (3/26), and it was most frequent deep to both the sartorius and gracilis (50 %, 13/26).

Conclusions

Edema between the PMFC, sartorius and/or gracilis tendons identified on knee MRI may be associated with medial knee pain and may represent a friction syndrome.

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References

  1. Strauss EJ, Kim S, Calcei JG, Park D. Iliotibial band syndrome: evaluation and management. J Am Acad Orthop Surg. 2011;19:728–36.

    PubMed  Google Scholar 

  2. Chung CB, Skaf A, Roger B, Campos J, Stump X, Resnick D. Patellar tendon-lateral femoral condyle friction syndrome: MR imaging in 42 patients. Skelet Radiol. 2001;30:694–7.

    Article  CAS  Google Scholar 

  3. Barbier-Brion B, Lerais J-M, Aubry S, et al. Magnetic resonance imaging in patellar lateral femoral friction syndrome (PLFFS): prospective case-control study. Diagn Interv Imaging. 2012;93:e171–82.

    Article  CAS  PubMed  Google Scholar 

  4. Subhawong TK, Eng J, Carrino JA, Chhabra A. Superolateral Hoffa’s fat pad edema: association with patellofemoral maltracking and impingement. AJR Am J Roentgenol. 2010;195:1367–73.

    Article  PubMed Central  PubMed  Google Scholar 

  5. Marchand AJ, Proisy M, Ropars M, Cohen M, Duvauferrier R, Guillin R. Snapping knee: imaging findings with an emphasis on dynamic sonography. AJR Am J Roentgenol. 2012;199:142–50.

    Article  PubMed  Google Scholar 

  6. Lokiec F, Velkes S, Schindler A, Pritsch M. The snapping biceps femoris syndrome. Clin Orthop Relat Res. 1992; 205–6.

  7. Cooper DE. Snapping popliteus tendon syndrome. A cause of mechanical knee popping in athletes. Am J Sports Med. 27:671–4

  8. Lyu SR, Wu JJ. Snapping syndrome caused by the semitendinosus tendon. A case report. J Bone Joint Surg Am. 1989;71:303–5.

    CAS  PubMed  Google Scholar 

  9. Bollen SR, Arvinte D. Snapping pes syndrome: a report of four cases. J Bone Joint Surg Br. 2008;90:334–5.

    Article  CAS  PubMed  Google Scholar 

  10. Klontzas ME, Akoumianakis ID, Vagios I, Karantanas AH. MR imaging findings of medial tibial crest friction. Eur J Radiol. 2013;82:e703–6.

    Article  PubMed  Google Scholar 

  11. Nogueira-Barbosa MH, de Moura LF. Posteromedial snapping knee related to the sartorius muscle. Radiol Bras. 2011;44:195–7.

    Article  Google Scholar 

  12. Sobczak S, Dugailly P-M, Feipel V, et al. In vitro biomechanical study of femoral torsion disorders: effect on moment arms of thigh muscles. Clin Biomech (Bristol, Avon). 2013;28:187–92.

    Article  CAS  Google Scholar 

  13. Noehren B, Davis I, Hamill J. Prospective study of the biomechanical factors associated with iliotibial band syndrome. Clin Biomech (Bristol, Avon). 2007;22:951–6.

  14. Geeslin AG, LaPrade RF. Surgical treatment of snapping medial hamstring tendons. Knee Surg Sports Traumatol Arthrosc. 2010;18:1294–6.

    Article  PubMed  Google Scholar 

  15. Tensho K, Aoki T, Morioka S, Narita N, Kato H, Saito N. Snapping pes syndrome after total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc. 2014;22:192–4.

    Article  CAS  PubMed  Google Scholar 

  16. Asopa V, Douglas RJ, Heysen J, Martin D. Diagnosing snapping sartorius tendon secondary to a meniscal cyst using dynamic ultrasound avoids incorrect surgical procedure. Case Rep Radiol. 2013;2013:813232.

    PubMed Central  PubMed  Google Scholar 

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Disclosure

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street-YAW 6048, Boston, MA, 02114, USA

    F. Joseph Simeone, Ambrose J. Huang, Connie Y. Chang, Maximilian Smith, Miriam A. Bredella & Martin Torriani

  2. Boston Sports Medicine and Research Institute, Boston, MA, USA

    Thomas J. Gill

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  1. F. Joseph Simeone
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  2. Ambrose J. Huang
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  3. Connie Y. Chang
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  4. Maximilian Smith
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  5. Thomas J. Gill
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  6. Miriam A. Bredella
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  7. Martin Torriani
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Correspondence to Martin Torriani.

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Simeone, F.J., Huang, A.J., Chang, C.Y. et al. Posteromedial knee friction syndrome: an entity with medial knee pain and edema between the femoral condyle, sartorius and gracilis. Skeletal Radiol 44, 557–563 (2015). https://doi.org/10.1007/s00256-014-2081-5

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  • DOI: https://doi.org/10.1007/s00256-014-2081-5

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