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📌 MRI Grading Systems
- Initial MRI grading systems relied on the pattern of muscle signal intensity alterations to classify muscle injuries into grades:
- Grade 0: Symptomatic injury without MRI findings
- Grade 1: Edema only, without architectural distortion
- Grade 2: Architectural distortion with intramuscular hemorrhage and tissue gaps
- Grade 3: Complete disruption of the musculotendinous junction
✅ Biceps Femoris Injuries
Biceps femoris injuries are most commonly described as:
- Avulsion or partial avulsion injuries
- Tears of the distal myotendinous junction
An association between partial tendinous avulsion of the biceps femoris and Segond fractures has been described.
✅ Case Summary In the case discussed, the patient presented with:
- ACL high-grade partial tear at the femoral attachment
- Small non-displaced Segond fracture
- No defect at the myotendinous junction of the biceps femoris muscle
- Feathery pattern muscle edema noted only in the biceps femoris short head muscle
Follow-up:
- Follow-up MRI two months later showed complete resolution
- Consistent with a Grade 1 muscle strain (edema only)
✅ Anatomical Review of distal musculotendinous junction of the biceps femoris
- Midportion: T-shaped low signal structure represents the distal musculotendinous junction of the biceps femoris
→ Formed by epimysial condensations of the long and short heads
- Distally, the posterolateral epimysial condensation of the short head forms the distal musculotendinous junction, appearing as a shallow convex structure.
RadioGraphics 2018; 38:124–148
AJR Am J Roentgenol. 2003 Mar;180(3):647-53
Orthop J Sports Med. 2017 Jul 20;5(7):2325967117714998
"Visualizing MSK Radiology: A Practical Guide to Radiology Mastery"
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#AcuteMuscleTear, #BicepsFemorisInjury, #MuscleTearGrading, #SegondFracture, #ACLTear, #MyotendinousJunctionTear, #MuscleBelly, #SportsInjury,
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