The detailed anatomy of the rectus femoris and corresponding injury appearances were first described in 1995. Since then, there has been little published to change our understanding of this complex anatomical area. More recent anatomical dissection work in 2004 and 2006 alluded to the presence of an altered configuration of the proximal tendon anatomy. Whilst widely accepted that the proximal rectus femoris muscle has two distinct tendon slips, the authors in 2006 described a third separate tendon slip arising from the anterior femoral capsule and this has been widely termed the ‘capsular head’. We provide evidence that imaging features corroborate this revised anatomical concept. Whilst the clinical relevance of these findings is yet to be established, it remains important that our understanding of the radiological anatomy in this area advances with the forward growth of imaging clarity. In this review, we revisit anatomical concepts and present atypical injury cases that may be explained by the presence of a separate capsular head.
Objectives:
The objectives of this study were to assess the diagnostic yield, accuracy, and complication rate of the US-guided core-needle biopsy technique for suspected soft-tissue sarcomas (STSs) and review this against other published practices.
Material and Methods:
A 5-year retrospective study was performed of consecutive US-guided percutaneous biopsy for suspected STSs, with 815 planned procedures in 799 patients (average age 57.8 years, [range 15–95] with 54.7% male). Diagnostic yield was recorded as positive for a sample that allowed differentiation of benign and malignant lesions. Diagnostic accuracy was defined as the correlation between biopsy and surgical specimen when excision was performed. Immediate and late complications were documented. The patient procedural experience was recorded by a departmental questionnaire.
Results:
Diagnostic yield was positive in 751/778 (96.5%) with no immediate, short- or long-term complications. Of 815 planned biopsies, 778 core biopsies were obtained. Of the 37 biopsy cases, where the tissue was not obtained, nine were not performed due to patient factors and a further 28 could not be obtained for other technical reasons (e.g., the lesion being too hard to penetrate or too painful to the core). 27/778 (3.5%) of biopsies were non-diagnostic (96.5%) and of these 27, nine patients were followed up clinically, 13 biopsies were repeated, and five cases were surgically excised without further biopsy attempts.
Conclusion:
The described soft-tissue mass US-guided percutaneous core-needle biopsy technique demonstrates a high diagnostic yield and accuracy with a low complication rate. The diagnostic yield appears comparable to data published by other institutions with more invasive techniques.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.