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Published in: Journal of Medical Case Reports 1/2019

Open Access 01-12-2019 | Magnetic Resonance Imaging | Case report

An anomalous band originating from the fabella causing semimembranosus impingement presenting as knee pain: a case report

Authors: V. Adukia, M. Ricks, K. Colquhoun, N. Flynn

Published in: Journal of Medical Case Reports | Issue 1/2019

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Abstract

Background

The presentation of patients with knee injuries which can have a significant impact on their ability to work and perform activities of daily living is constantly rising. The posterolateral corner of the knee has a complex anatomy of muscles, tendons, and ligaments, with huge variation in the population. The fabella is one such structure, found in the posterolateral corner of the knee, which can serve as a common origin point of various ligaments.

Case report

We present a case report of a 53-year-old white man who presented with atraumatic, posterior knee pain and was found to have a congenital, anomalous band originating from the fabella, causing semimembranosus impingement. This was diagnosed with magnetic resonance imaging; he underwent division of the anomalous band, which resulted in complete resolution of his symptoms.

Conclusion

We propose that patients who present with posterior knee pain, without any history of trauma, and have no abnormalities on plain radiographs, should undergo magnetic resonance imaging of their knees. This will help in assessing the ligament complex in the posterior compartment of the knee, and exclude impingement of the semimembranosus as an, albeit rare, cause of posteromedial knee pain.
Literature
2.
go back to reference Pacheco RJ, Ayre CA, Bollen SR. Posterolateral corner injuries of the knee: a serious injury commonly missed. J Bone Joint Surg Br. 2011;93 ((2):194–7.CrossRef Pacheco RJ, Ayre CA, Bollen SR. Posterolateral corner injuries of the knee: a serious injury commonly missed. J Bone Joint Surg Br. 2011;93 ((2):194–7.CrossRef
3.
go back to reference Shon OJ, Park JW, Kim BJ. Current concepts of posterolateral corner injuries of the knee. Knee Surg Relat Res. 2017;29(4):256–68.CrossRef Shon OJ, Park JW, Kim BJ. Current concepts of posterolateral corner injuries of the knee. Knee Surg Relat Res. 2017;29(4):256–68.CrossRef
4.
go back to reference Kawashima T, Takeishi H, Yoshitomi S, Ito M, Sasaki H. Anatomical study of the fabella, fabellar complex and its clinical implications. Surg Radiol Anat. 2007;29:611–6.CrossRef Kawashima T, Takeishi H, Yoshitomi S, Ito M, Sasaki H. Anatomical study of the fabella, fabellar complex and its clinical implications. Surg Radiol Anat. 2007;29:611–6.CrossRef
5.
go back to reference Tabira Y, Saga T, Takahashi N, Watanabe K, Nakamura M, et al. Influence of a fabella in the gastrocnemius muscle on the common fibular nerve in Japanese subjects. Clin Anat. 2013;26(7):893–902.PubMed Tabira Y, Saga T, Takahashi N, Watanabe K, Nakamura M, et al. Influence of a fabella in the gastrocnemius muscle on the common fibular nerve in Japanese subjects. Clin Anat. 2013;26(7):893–902.PubMed
6.
go back to reference Driessen A, Balke M, Offerhaus C, White WJ, Shafizadeh S, et al. The fabella syndrome – a rare cause of posterolateral knee pain: a review of the literature and two case reports. BMC Musculoskelet Disord. 2014;15:100.CrossRef Driessen A, Balke M, Offerhaus C, White WJ, Shafizadeh S, et al. The fabella syndrome – a rare cause of posterolateral knee pain: a review of the literature and two case reports. BMC Musculoskelet Disord. 2014;15:100.CrossRef
7.
go back to reference Minowa T, Murakami G, Kura H, Suzuki D, Han SH, et al. Does the fabella contribute to the reinforcement of the posterolateral corner of the knee by inducing the development of associated ligaments? J Orthop Sci. 2004;9(1):59–65.CrossRef Minowa T, Murakami G, Kura H, Suzuki D, Han SH, et al. Does the fabella contribute to the reinforcement of the posterolateral corner of the knee by inducing the development of associated ligaments? J Orthop Sci. 2004;9(1):59–65.CrossRef
9.
go back to reference Tyler P, Datir A, Saifuddin A. Magnetic resonance imaging of anatomical variations in the knee Part 1: ligamentous and musculotendinous. Skeletal Radiol. 2010;39(12):1161–73.CrossRef Tyler P, Datir A, Saifuddin A. Magnetic resonance imaging of anatomical variations in the knee Part 1: ligamentous and musculotendinous. Skeletal Radiol. 2010;39(12):1161–73.CrossRef
10.
go back to reference Yoon MA, Choi JY, Lim HK, Yoo HJ, Hong SH, et al. High prevalence of abnormal MR findings of the distal semimembranosus tendon: contributing factors based on demographic, radiographic, and MR features. AJR Am J Roentgenol. 2014;202(5):1087–93.CrossRef Yoon MA, Choi JY, Lim HK, Yoo HJ, Hong SH, et al. High prevalence of abnormal MR findings of the distal semimembranosus tendon: contributing factors based on demographic, radiographic, and MR features. AJR Am J Roentgenol. 2014;202(5):1087–93.CrossRef
Metadata
Title
An anomalous band originating from the fabella causing semimembranosus impingement presenting as knee pain: a case report
Authors
V. Adukia
M. Ricks
K. Colquhoun
N. Flynn
Publication date
01-12-2019
Publisher
BioMed Central
Published in
Journal of Medical Case Reports / Issue 1/2019
Electronic ISSN: 1752-1947
DOI
https://doi.org/10.1186/s13256-018-1946-y

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