Yunkyung Shin, Presenter: Nothing to Disclose

Kyung Nam Ryu MD, PhD, Abstract Co-Author: Nothing to Disclose

Ji Seon Park MD, PhD, Abstract Co-Author: Nothing to Disclose

Wook Jin, Abstract Co-Author: Nothing to Disclose

Han Na Lee MD, Abstract Co-Author: Nothing to Disclose

So Young Park, Abstract Co-Author: Nothing to Disclose

Biceps femoris tendon(BFT) and lateral collateral ligament(LCL) in knee were formerly known to form a conjoined tendon at fibular attachment site. However, biceps femoris tendon lateral collateral ligament insert into the fibular head in a variety of patterns. Understanding of such anatomical variance would help to reduce misdiagnoses in the corresponding area. We classified insertion patterns of BFT and LCL using MR imaging, and analyzed whether LCL attaches to fibular head or not.

A total of 494 consecutive knee MRIs of 470 patients taken between July 2012 and December 2012 were retrospectively reviewed. There were 224 males and 246 females, and the patient age varied from 10 to 88 (mean, 48.6). The exclusion criteria were previous surgery and poor image quality. Using 3T fat-suppressed proton density-weighted axial images, fibular insertion patterns of BFT and LCL were classified into the following types: type I(LCL passes between anterior arm and direct arm of long head of BFT), type II(LCL joins with anterior arm of long head of BFT), type III(BFT and LCL join to form a conjoined tendon), type IV(LCL passes laterally around the anterior margin of BFT), and type V(LCL passes posteriorly to the direct arm of long head of BFT).

Among the 494 cases of knee MRI, there were 433(87.65%) type I cases, 21(4.25%) type II cases, 2(0.4%) type III cases, 16(3.23%) type IV cases, and 22(4.45%) type V cases. There were 26 cases(5.26%) in which LCL and BFT did not insert into fibular head.

Only a small fraction of subjects showed a conjoined tendon at fibular insertion of BFT and LCL. Fibular attachment pattern of BFT and LCL shows various types in MR imaging. Lateral collateral ligaments do not insert into the fibular head in some patients.

An understanding of insertion pattern of BFT and LCL will be helpful to evaluate tendons in reading knee MRIs.

Shin, Y, Ryu, K, Park, J, Jin, W, Lee, H, Park, S, Biceps Femoris Tendon and Lateral Collateral Ligament: Analysis of Insertion Pattern Using MRI.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14005267.html