MR imaging of the quadriceps tendon: normal layered configuration and its importance in cases of tendon rupture.

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Abstract
The quadriceps tendon is a multilayered structure with separate layers arising from different muscle groups. We examined this layered configuration on MR images to determine if it is relevant in the evaluation of the traumatized quadriceps tendon.Sagittal and axial T1-weighted MR images of 52 knees with normal tendons were reviewed to determine the number and the muscle origins of these layers. Five knees with traumatized quadriceps tendons were imaged with T1 and T2 weighting to determine the relationship between the layered configuration and the injury.All the normal quadriceps tendons had a laminated appearance with either four (6%), three (56%), or two (30%) layers. In 8%, the laminations were barely perceptible. The site of origin of each layer was consistent, and each favored a given muscle. The superficial layer originated from the posterior fascia of the rectus femoris muscle, and the deep layer originated from the anterior fascia of the midline vastus intermedius muscle. The middle layer(s) arose...

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