Heterotopic ossification of the indirect rectus femoris tendon

Clinical Information

Male, 32 year, physiotherapist and recreative soccer player with acute onset of ventral hip pain during a soccer game since 3 months. Sharp pain. Provocation of pain during walking, starting-up, sports activities. Reduction: rest and adjusting load. Presumably normal course of the complaint. NPRS: at first: 8, at the moment 0, during sport activities: 7. No prior history of ventral hip pain.

Brief Description

After 3 months mild pain during sport activities and pain free at rest. Injury mechanism: extension, exorotation and abduction hip with ipsilateral rotation of the trunk. Ultrasound findings: Shape: severe thickened indirect tendon, mild thickened direct tendon Echogenicity: hypo echoic indirect tendon, hyper echoic part around the intramuscular part of the tendon Continuity: abnormal fibrillary pattern of the indirect tendon, normal fibrillary pattern of the direct tendon Doppler: grade 0 doppler signal

Ultrasound Images & Clips


Moderate to severe tendinosis of the indirect rectus femoris tendon with heterotopic ossification and mild muscular scar tissue around the intra muscular indirect tendon. Possibly due to the previous injury in the past, mild tendinosis of the direct tendon.