Ebook Imaging anatomy musculoskeletal (2nd edition): Part 2

SECTION 8

Thigh

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Thigh

Thigh Radiographic Anatomy and MR Atlas

TERMINOLOGY
Abbreviations
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•
•
•
•
•
•

Anterior superior iliac spine (ASIS)
Function (F)
Muscle insertion (I)
Nerve supply (N)
Muscle origin (O)
Structure supplied by nerve or vessel (S)
Sacroiliac joint (SI)

IMAGING ANATOMY
Bony Anatomy of Femur
• Femoral head
○ 2/3 of sphere sitting on cylindrical femoral neck
○ Fovea capitis: Medial concavity for attachment of
ligamentum teres
• Femoral neck
○ Connects head to intertrochanteric region
• Trochanters
○ Greater: Superior/posterior projection from femoral
neck/shaft junction
○ Lesser: Posterior/medial projection from femoral
neck/shaft junction
○ Joined by intertrochanteric crest
• Shaft
○ Bowed anteriorly, inclined medially
○ Linea aspera on posterior surface; multiple muscle
attachments
• Condyles
○ Medial and lateral condyles separated by intercondylar
notch
○ Epicondyles superior margin of condyles

Compartment Anatomy
• Thigh divided into 3-4 soft tissue compartments
○ Anterior compartment: Iliotibial tract, tensor fascia lata
m., quadriceps muscles (sartorius m.)
○ Medial compartment: Gracilis muscle, adductor muscles
○ Posterior compartment: Hamstring muscles, short head
of biceps femoris muscle, sciatic nerve

○ Sartorius is often considered separate compartment
• Muscles at junction pelvis/thigh: Each considered separate
compartment
○ Pectineus, iliopsoas, obturator externus, lateral femoral
muscles
• Extensions from fascia lata divide compartments
○ Medial intermuscular septum: Anterior/medial
○ Lateral intermuscular septum: Anterior/lateral
○ Thin fascia separates medial, posterior compartments
• Clinical note: Compartment anatomy critical to tumor
staging and biopsy planning
○ Cross compartment extension of tumor, contamination
by biopsy may require change from limb salvage to
amputation

Medial Thigh Muscles
• F: Hip adduction; assist hip flexion, internal rotation
○ Except obturator externus muscle (external rotation of
hip)
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• Adductor longus
○ O: Pubic body inferior to crest
○ I: Medial lip linea aspera
○ N: Posterior division of obturator nerve
• Adductor brevis lies posterior to adductor longus
○ O: Inferior pubic ramus
○ I: Inferior 2/3 of pectineal line, superior 1/2 of medial lip
of linea aspera
○ N: Posterior division of obturator nerve

• Adductor magnus: Massive, posteromedial muscle can be
divided into 3 parts
○ N: Posterior division obturator nerve, except
ischiocondylar portion innervated by tibial nerve
○ Adductor minimus
– O: Pubic ramus
– I: Gluteal tuberosity of femur, medial to gluteus
maximus
○ Adductor and ischiocondylar portion of adductor
magnus
– O: Ischiopubic ramus, ischial tuberosity
– I: Wide insertion on medial lip linea aspera, medial
supracondylar line
□ 5 aponeurotic openings in insertion sites
□ 4 openings transmit perforating branches and
terminus of profunda femoris a.
□ Lowest opening is adductor hiatus, through which
superficial femoral vessels pass into popliteal fossa
– Ischiocondylar portion is most medial (hamstring)
portion, inserts on medial supracondylar line
• Gracilis
○ O: Inferior pubic ramus, symphysis pubis
○ I: Medial proximal tibia (pes anserine)
○ F: Also assists knee flexion
• Obturator externus
○ O: External margins of obturator foramen and
membrane
○ I: Piriformis fossa
○ F: Hip external rotation only
• Pectineus

○ O: Superior pubic ramus, pecten
○ I: Pectineal line femur
○ Femoral nerve ± accessory obturator nerve

Anterior Thigh Muscles
• Common innervation: Femoral nerve
• Common function: Knee extension (except sartorius)
• Sartorius (tailor's) muscle
○ O: ASIS, notch below
○ I: Proximal medial tibia (pes anserine)
○ F: Hip flexion, abduction, external rotation; knee flexion
○ Crosses hip and knee joints
○ Longest muscle in body
○ Separate fascial covering
• Quadriceps femoris: Rectus femoris, vastus lateralis, vastus
medialis, vastus intermedius muscles
○ Common tendon of insertion onto superior, lateral,
medial patella
• Rectus femoris
○ O: Straight head: Anterior inferior iliac spine


Thigh Radiographic Anatomy and MR Atlas

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•

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Iliotibial Tract/Band: Lateral Thickening Fascia Lata
• O: Tubercle iliac crest
• I: Lateral condyle tibia
• Insertion site of tensor fascia lata muscle and portion of
gluteus maximus muscle

Posterior Thigh Muscles
• Common nerve: Sciatic nerve
○ Tibial division: Long head of biceps femoris,
semitendinosus, semimembranosus, ischiocondylar
portion adductor magnus muscles
○ Common peroneal division: Short head of biceps femoris
muscle
• Common functions: Hip extension, knee flexion
• Hamstrings: Long head of biceps femoris,
semimembranous, semitendinosus, ischiocondylar portion
adductor magnus muscles
○ Does not include short head of biceps femoris m.
• Biceps femoris
○ Long head: O: Ischial tuberosity (inferior, medial)
– Common tendon with semitendinosus muscle
○ Short head: O: Lateral lip linea aspera femur, lateral
supracondylar line, lateral intermuscular septum
– Post-axial muscle
– Not part of hamstring muscles
○ I: Fibular head, lateral condyle tibia
○ F: Also external rotation flexed knee
• Semimembranosus
○ O: Ischial tuberosity (superior, lateral)
○ I: Posterior medial condyle tibia, popliteal fascia

– Some fibers extend to form oblique popliteal l. (see
"Knee Medial Supporting Structures" chapter)
○ F: Also internal rotation flexed knee

○ Membranous in upper thigh
• Semitendinosus
○ O: Ischial tuberosity (inferior, medial)
– Common tendon long head of biceps femoris m.
○ I: Medial proximal tibia (pes anserine)
○ F: Also internal rotation flexed knee
○ Entirely tendinous in distal thigh

Thigh

•

○ O: Reflected head: Lateral ilium, in groove above
acetabulum
○ I: Superior patella, tibial tuberosity
○ F: Also hip flexion
○ Crosses hip and knee joints
Vastus lateralis
○ O: Superior intertrochanteric line femur, anterior and
inferior greater trochanter, gluteal tuberosity, lateral lip
linea aspera, lateral intermuscular septum
○ I: Lateral patellar retinaculum, superolateral patella,
rectus femoris tendon
○ Largest quadriceps muscle
Vastus medialis
○ O: Entire medial lip linea aspera, inferior

intertrochanteric line, medial intermuscular septum
○ I: Tendon rectus femoris muscle, superomedial patella
(quadriceps tendon), medial condyle tibia (medial
patellar retinaculum)
Vastus intermedius
○ O: Anterior and lateral femoral shaft, inferior lateral lip
linea aspera, lateral intermuscular septum
○ I: Blends along deep aspect rectus femoris, vastus
medialis, vastus lateralis muscles
Articularis genu
○ O: Anterior lower femur
○ I: Synovial membrane knee
○ N. to vastus intermedius

Hip Flexors
• Sartorius: Anterior femoral muscle
• Pectineus: Medial femoral muscle
• Iliopsoas: I: Lesser trochanter
○ Iliacus
– O: Iliac crest, iliac fossa, sacral ala, SI joint capsule
– N: Femoral nerve
○ Psoas major
– O: Lateral vertebral body and intervertebral discs T12L5, all lumbar transverse processes
– N: L1, L2, L3
○ Psoas minor
– O: Lateral vertebral body T12, L1 and T12-L1
intervertebral disc
– N: L1, L2

Femoral Triangle

• Anterior wall: Inguinal ligament
• Posterior wall: Adductor longus and pectineus muscles
(medial), iliopsoas muscle (lateral)
• Medial border: Adductor longus muscle
• Lateral border: Sartorius muscle
• Apex: Crossing adductor longus and sartorius muscles
• Contents: Femoral nerve and branches, femoral vessels,
lymph node (Cloquet node), femoral sheath
○ Structures lateral to medial at entrance: NAVeL: Nerve,
artery, vein, lymphatics
• Femoral artery/vein relationships
○ Entrance: Artery lateral
○ Apex: Artery anterior
• Femoral nerve branches within triangle
○ Saphenous nerve, and nerve to vastus medialis only
branches to exit triangle
• Femoral sheath: Transversalis fascia covers vessels
proximally
○ 3 compartments: Lateral (artery), middle (vein), medial
(femoral canal)
• Femoral canal: Medial compartment femoral sheath
○ Anterior border: Inguinal ligament
○ Posterior border: Pubic bone
○ Medial border: Lacunar ligament
○ Lateral border: Femoral vein
○ Entrance: Femoral ring
– Anterior border: Medial inguinal ligament
– Posterior border: Superior pubic ramus
– Medial border: Lacunar ligament
– Lateral border: Septum between femoral canal and

femoral vein
– Open to peritoneal cavity
○ Contents: Lymphatic vessels and nodes (Cloquet node),
fat, connective tissue

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Adductor (Subsartorial or Hunter) Canal
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Vessel passageway from thigh to popliteal fossa
Anteromedial border: Sartorius muscle
Anterolateral border: Vastus medialis muscle
Posterior border: Adductor longus and magnus muscles
Entrance: Apex femoral triangle, exit adductor hiatus
○ Adductor hiatus: Gap in adductor magnus muscle
between adductor portion and ischiocondylar portion
distal thigh
• Contents: Femoral artery and vein, saphenous nerve
○ Nerve initially anterior to artery, then medial
○ Artery anterior to vein

○ Descending geniculate artery arises in canal

Femoral Vessels
• Enter thigh deep to inguinal ligament, midpoint between
ASIS and symphysis pubis
• Upper thigh: Vessels within femoral triangle
○ Enter: Artery lateral to vein
○ Exit: Artery anterior
• Mid thigh: Vessels within adductor canal
○ Entrance: Artery anterior
○ Exit: Artery anterior
• Distal thigh: Exit adductor canal via adductor hiatus, enter
popliteal fossa
• Common femoral artery branches
○ Superficial epigastric, superficial circumflex iliac,
superficial external pudendal arise anteriorly
○ Deep external pudendal arises medially
– May branch from medial circumflex femoral
○ Divides into superficial and deep branches
○ Superficial femoral artery
– Branch: Descending genicular
○ Deep femoral (profunda femoris)
– Arises laterally in femoral triangle
– Dives between pectineus and adductor longus
muscles
– Medial to femur, deep to adductor longus muscle
– Branches in femoral triangle: Medial circumflex
femoral (main supply to femoral head and neck),
lateral circumflex femoral, muscular branches
– Branches in adductor canal: 3 perforating branches,

descending genicular
– Terminal branch: 4th perforating artery
• Femoral vein: Travels with artery
○ Tributaries: Deep femoral, descending genicular, lateral
circumflex femoral, medial circumflex femoral, deep
external pudendal, greater saphenous veins
○ Greater saphenous vein
– Longest vein in body
– Toes to saphenous opening (fascia lata)
– Tributaries: Accessory saphenous, superficial
epigastric, superficial circumflex femoral, superficial
external pudendal veins

Femoral Nerve
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L2, L3, L4, L5; post axial
Largest branch lumbar plexus
Exits plexus lower psoas muscle
Travels in groove between psoas and iliacus muscles

• Exits pelvis beneath inguinal ligament, lateral to femoral
vessels, enters femoral triangle
• Multiple branches in femoral triangle
○ Muscular branches: To pectineus, sartorius, rectus
femoris, vastus lateralis, vastus medialis, vastus

intermedius muscles
○ Cutaneous nerves: Anterior femoral cutaneous,
saphenous
– Saphenous nerve exits triangle, enters adductor canal
○ Articular branches hip and knee

Obturator Nerve
• L2, L3, L4; pre axial
• Branch lumbar plexus
• Relationships
○ Posterior to iliac vessels
○ Medial to psoas muscle
○ Lateral to internal iliac vessels
• Via obturator foramen to thigh
• S: Adductor muscles, hip and knee joints, skin medial distal
thigh
• Accessory obturator nerve: L3, L4
○ Present in 9%

Sciatic Nerve
• L4, L5, S1, S2, S3, largest branch of sacral plexus
• 2 nerves in 1 sheath
○ Tibial nerve (medial) and common peroneal nerve
(lateral)
○ Separate in lower thigh
• Exits pelvis inferior to piriformis muscle
• Crosses over superior gemellus, obturator internus, inferior
gemellus, quadratus femoris, adductor magnus muscles
• Deep to long head of biceps femoris muscle
• Branches arising in thigh: Articular to hip, nerves to

hamstring muscles
• Tibial nerve: Larger division of sciatic nerve
○ S: Posterior femoral muscles except short head of biceps
femoris muscle
• Common peroneal nerve
○ Oblique lateral course with biceps femoris muscle
○ S: Short head of biceps femoris muscle

Fascia of Thigh
• Fascia lata: Encase entire thigh
○ Superior attachment: Inguinal ligament
• Iliotibial tract: Lateral thickening of fascia lata
○ Superior attachment: Tubercle of iliac crest
○ Inferior attachment: Lateral tubercle of tibial condyle
(Gerdy tubercle)
○ Insertion site of portions of gluteus maximus and tensor
fascia lata muscles
• Lateral intermuscular septum: Separates vastus lateralis
and biceps femoris muscles
• Medial intermuscular septum: Separates adductor and
vastus medialis muscles


Thigh Radiographic Anatomy and MR Atlas
Thigh

ANTERIOR THIGH
Iliacus m.
Sartorius m.
Rectus femoris, direct head

Gluteus minimus m.
Vastus lateralis m.
Iliopsoas m.
Vastus medialis m.
Vastus intermedius m.

Pectineus muscle
Adductor longus m.
Gracilis muscle
Adductor brevis m.
Obturator externus m.
Adductor magnus m.

Articularis genu m.

Quadratus femoris m.

Adductor magnus m.
Iliotibial band
Patellar ligament

Iliacus muscle
Psoas muscle
Anterior superior iliac spine
Tensor fascia lata m.
Sartorius muscle
Iliotibial band

Pectineus muscle
Adductor brevis m.

Adductor longus m.
Gracilis muscle

Rectus femoris m.
Vastus lateralis m.
Vastus medialis m.
Lateral patellar retinaculum

Medial patellar retinaculum
Pes anserine tendons

Iliacus muscle
Psoas muscle

Lesser trochanter

Iliotibial band

Pectineus muscle
Adductor brevis m.
Adductor longus m.

Vastus intermedius m.
Vastus lateralis m.
Vastus medialis m.
Lateral patellar retinaculum

Medial patellar retinaculum
Pes anserine tendons

(Top) Muscle and ligament attachments of the anterior pelvis and femur are shown. The 3 vasti muscles that form part of the
quadriceps group are the primary muscles arising from the anterior femur. Adductor magnus inserts on the adductor tubercle just above
the medial femoral condyle. (Middle) Superficial muscles of the anterior thigh are shown. The oblique course of the sartorius muscle is
easily appreciated. The adductor brevis muscle is deep to the adductor longus and pectineus muscles. The most medial muscle is the
gracilis. The vastus lateralis and medialis muscles continue to their insertions on the lateral and medial patellar margins, respectively.
(Bottom) Deep muscles of the anterior thigh are shown. The vastus intermedius muscle is deep to the rectus femoris muscle. With the
removal of the sartorius muscle, a little more of the adductor brevis muscle is visible. The sartorius, gracilis, and semitendinosus tendons
combine to form the pes anserinus, inserting on the tibia just distal and anterior to the medial collateral ligament.

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POSTERIOR THIGH
Superior gemellus m.
Inferior gemellus m.
Quadratus femoris
Semimembranosus m.
Biceps femoris m., long head
Semitendinosus m.
Adductor magnus m.
Iliopsoas m.
Pectineus m.
Adductor brevis m.
Adductor longus m.
Adductor magnus m.
Gastrocnemius m., medial head

Semimembranosus m.
Popliteus m.

Gluteus medius m.
Gluteus maximus m.
Gluteus minimus m.
Rectus femoris m., reflected head
Gluteus medius m.
Obturator externus m.
Quadratus femoris m.
Vastus lateralis m.
Gluteus maximus m.
Adductor magnus m.
Vastus intermedius m.
Biceps femoris m., short head
Vastus lateralis m.
Vastus medialis m.
Plantaris m.
Gastrocnemius m., lateral head
Soleus m.

Gluteus minimus m.
Gluteus medius m.
Gluteus maximus m.

Adductor magnus m.
Gracilis muscle
Semitendinosus m.
Semimembranosus m.

Biceps femoris m.
Iliotibial band
Popliteal fossa

Gracilis tendon

Piriformis muscle
Obturator internus m.
Sacrotuberous ligament
Adductor magnus m.
Gracilis muscle
Ischiocondylar portion, adductor magnus
m.

Gluteus minimus m.
Gluteus medius m.
Superior gemellus m.
Inferior gemellus m.
Quadratus femoris m.
Vastus lateralis m.

Short head, biceps femoris muscle

Adductor hiatus
Gracilis tendon

(Top) Muscle and ligament attachments of the posterior pelvis and femur are shown. The adductor brevis muscle insertion is superior to
the adductor longus muscle. The transverse head of the adductor magnus (a.k.a. adductor minimus) inserts just medial to the gluteus
maximus muscle. The ischiocondylar head has a long insertion on the posterior femur. (Middle) Superficial muscles of the posterior thigh
are shown. The gluteus muscles from anterior to posterior and deep to superficial are gluteus minimus, medius, and maximus. The

semitendinosus muscle is superficial to the semimembranosus muscle. The semimembranous muscle originates lateral to the conjoined
origin of biceps and semitendinosus. (Bottom) Deep muscles of the posterior thigh are shown. With the removal of the hamstring
muscles, the expansive adductor magnus muscle is visible. The separation of its 2 heads in the distal thigh forms the adductor hiatus.
The femoral vessels pass through the hiatus into the popliteal fossa.

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Thigh

COMPARTMENTS OF THIGH

Sartorius
Anterior compartment

Medial compartment

Posterior compartment

Anterior compartment
Sartorius m.

Medial compartment

Posterior compartment

Anterior compartment

Sartorius m.

Medial compartment
Posterior compartment

(Top) There are 3 soft tissue compartments of the thigh: Anterior, containing the quadriceps, medial, containing the adductors, and
posterior, containing the hamstrings. The sartorius can be considered part of the anterior or medial compartments, but it has a separate
fascial sheath and is often considered a separate compartment. (Middle) Fascial compartments at the level of the mid thigh are shown.
The medial compartment has enlarged, whereas the posterior compartment has decreased in size. (Bottom) Compartments of the distal
thigh are shown. Compartments of the thigh are an important anatomic consideration for tumor biopsy and resection, since care must
be taken not to traverse more than 1 compartment to avoid wide contamination of the tumor.

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ARTERIAL ANATOMY OF THIGH
Common iliac artery

Internal iliac artery

Deep circumflex iliac artery

Obturator artery
Inferior epigastric a.

Superficial epigastric a.

External pudendal a.

Superficial circumflex iliac
artery

Common femoral a.
Medial femoral circumflex a.

Lateral circumflex femoral
artery

Muscular branches
Deep femoral a.
Superficial femoral a.

Perforating vessels
Descending branch lateral
circumflex femoral artery
Superior lateral genicular
artery
Inferior lateral genicular artery

Popliteal artery
Descending genicular artery
Superior medial genicular
artery
Inferior medial genicular
artery

Superior gluteal artery
Inferior gluteal artery

Medial circumflex femoral
artery

Ascending and descending
branches medial circumflex

Muscular branches
Perforating arteries
Superficial femoral a.
Descending genicular artery

Descending branch lateral
circumflex femoral artery

Popliteal artery
Superior medial genicular
artery
Inferior medial genicular a.

Superior lateral genicular
artery
Inferior lateral genicular artery

(Top) Anterior view of the arteries of the thigh is shown. Deep femoral artery (a.k.a. profunda femoris artery) gives rise to the
circumflex femoral arteries. It supplies the musculature of the thigh. Lateral femoral circumflex artery travels posterior to the rectus
femoris muscle and wraps around the anterior portion of the femoral neck. (Bottom) Posterior view of the femoral and popliteal
arteries and the superior and inferior gluteal arteries of the greater sciatic notch is shown. Medial circumflex femoral artery wraps
around posterior femoral neck.

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Thigh

VENOUS ANATOMY OF THIGH
Common iliac vein
Deep circumflex iliac vein
Internal iliac vein
Common femoral vein
Medial circumflex femoral vein

Inferior epigastric v.
Obturator vein
Greater saphenous v.
Lateral circumflex femoral
vein

Perforating veins

Deep femoral vein
Superficial femoral v.

Popliteal vein

Obturator vein

Superior gluteal v.
Inferior gluteal v.
Medial circumflex v.

Superficial femoral vein

Deep femoral v.
Perforating veins

Popliteal vein

(Top) Anterior view of the deep veins of the thigh is shown. The deep veins typically follow the arterial tree. The main venous drainage
is the superficial femoral vein, which is (confusingly) part of the deep venous system. Note the entrance of the greater saphenous vein
into the femoral vein; it has no associated artery. (Bottom) Posterior view of the veins of the thigh and buttocks is shown. Superficial
femoral vein becomes the popliteal vein in the popliteal fossa.

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Thigh Radiographic Anatomy and MR Atlas

SCIATIC NERVE AND DERMATOMES

Piriformis muscle
Obturator internus m.

Gemelli muscles
Quadratus femoris m.
Sciatic nerve

Biceps femoris m.

Common peroneal n.
Tibial nerve

(Top) The sciatic nerve enters the lower extremity by passing under the inferior border of the piriformis muscle. The sciatic nerve passes
posterior to the external rotator tendons and then courses deep to the biceps femoris muscle. The tibial and peroneal divisions of the
sciatic nerve are visible throughout its course. They diverge in the distal thigh. The tibial nerve bisects the popliteal fossa. The common
peroneal nerve follows the biceps femoris muscle around the fibular head. (Bottom) Dermatomes of the anterior (A, C), posterior (B, D),
lateral (E), and medial (F) thigh are shown. Two different patterns are recognized for the anterior and posterior thigh, as represented by
the 2 diagrams.

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Thigh

MEDIAL THIGH MUSCLES, FEMORAL TRIANGLE
Iliac crest
Anterior superior iliac spine
Iliacus muscle
Psoas muscle
Obturator membrane

Ischial spine

Sacrospinous ligament
Sacrotuberous ligament
Gluteus maximus m.

Adductor longus m.
Gracilis muscle

Adductor magnus m.

Rectus femoris m.
Sartorius muscle

Semimembranosus m.

Vastus medialis m.
Semitendinosus m.
Medial patellar retinaculum
Pes anserine

Iliacus muscle
Femoral nerve

Psoas muscle
Femoral canal/Cloquet node

Common femoral a.
Common femoral v.

Inguinal ligament
Symphysis pubis

Tensor fascia lata m.

Pubic tubercle

Pectineus muscle

Rectus femoris m.
Apex femoral triangle

Sartorius m. (cut away)

Adductor longus m.

Gracilis muscle

(Top) Medial muscles of the thigh are shown. The gracilis muscle has a thin profile when viewed from the front, however, when viewed
from the side, it is quite broad. The semimembranosus muscle runs along the deep surface of the semitendinous muscle and inserts onto
the tibia posterior to the pes anserine tendons. Its insertion is hidden on this image. The iliopsoas muscle courses over the pelvic brim on
its course to the lesser trochanter. (Bottom) The contents of the femoral triangle from lateral to medial (NAVeL) are femoral nerve,
femoral artery, femoral vein, and lymphatics. The nerve lies superficial to the iliopsoas muscle. The lateral border of the triangle is the
sartorius muscle. The anterior wall is the inguinal ligament. The fascia lata encases the structures of the thigh. The femoral sheath is
the fascial covering over the proximal vessels. At the cutaway proximal boundary, note the septa dividing the sheath into
compartments. The femoral canal is the medial compartment.

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PROXIMAL FEMUR RADIOGRAPHS
Iliac crest
Sacroiliac joint

Sacral arc

Iliac wing
Fovea capitis

Sacrum

Femoral head
Subcapital region

Teardrop
Superior pubic ramus
Pubic tubercle

Basicervical region
Greater trochanter
Intertrochanteric crest

Symphysis pubis
Pubic body

Lesser trochanter

Inferior ramus
Obturator foramen
Ischial tuberosity
Femoral diaphysis

Iliac crest

Iliac wing
Sacroiliac joint
Anterior inferior iliac spine
Teardrop
Superior pubic ramus
Pubic tubercle

Femoral head
Greater trochanter

Symphysis pubis
Lesser trochanter
Pubic body
Inferior ramus
Obturator foramen
Ischial tuberosity

Femoral diaphysis

Linea aspera

(Top) AP radiograph shows the proximal femur. Note the regions of the proximal femur: The subcapital region at the junction of the
femoral head and neck, the basicervical region at the base of the femoral neck. For descriptive purposes, fractures between the
basicervical and subcapital regions are referred to as transcervical (not labeled). In a well-positioned AP femur the lesser trochanter
points medial and posterior. The intertrochanteric crest, a posterior prominence connecting the 2 trochanters, is visible. The fovea
capitis appears as a central depression on the femoral head. (Bottom) Lateral view of the proximal femur is shown. With external
rotation, the lesser trochanter is now seen in profile, its inferior cortex blending with the cortex of the adjacent femoral neck. The
femoral head, neck, and greater trochanter are all overlapping.

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Thigh Radiographic Anatomy and MR Atlas

Femoral diaphysis

Thigh

DISTAL FEMUR RADIOGRAPHS

Linea aspera

Medial supracondylar line
Lateral supracondylar line

Adductor tubercle
Patella

Quadriceps muscles
Nutrient groove
Linea aspera

Medial femoral condyle

Fabella
Lateral femoral condyle

(Top) The femoral shaft has a slight medial slant that balances the lateral slant of the femoral neck. Note the prominent linea aspera,
which divides inferiorly into medial and lateral supracondylar lines. Hyperostosis of the linea aspera is common in older patients.
(Bottom) Lateral radiograph of the distal femur shows a posterior flange, known as the linea aspera. The linea aspera is a site of

multiple muscle attachments. Nutrient groove enters the posterior femur at the midshaft and courses superiorly and anteriorly in the
femoral shaft. Fabella is a variably present sesamoid in the lateral head of the gastrocnemius.

617


Thigh

Thigh Radiographic Anatomy and MR Atlas

AXIAL T1 MR, UPPER RIGHT THIGH
Sartorius m.
Common femoral artery, vein and nerve

Tensor fascia lata m.
Gluteus minimus m.
Gluteus medius t.
Femoral neck

Iliopsoas muscle
Pectineus muscle
Rectus femoris m.
Acetabular fossa
Ischium
Obturator internus m.

Obturator externus m.
Quadratus femoris m.

Gluteus maximus m.

Sciatic n.

Sartorius m.
Common femoral artery & vein
Pectineus muscle
Iliopsoas muscle
Adductor brevis m.
Iliotibial band
Rectus femoris m.
Vastus lateralis m.

Obturator externus m.
Obturator internus m.
Ischium
Semimembranosus t.
Conjoined origin long head of biceps
femoris m. and semitendinosus m.

Femoral neck
Quadratus femoris m.

Gluteus maximus m.

Sciatic nerve

Sartorius muscle
Common femoral artery, vein and nerve
Pectineus m.
Adductor brevis m.

Obturator externus m.
Tensor fascia lata m.
Iliotibial band
Rectus femoris m.
Gluteus medius t.
Vastus lateralis m.
Quadratus femoris m.

Obturator internus m.
Ischial tuberosity
Semimembranosus t.
Conjoined origin long head of biceps
femoris m. and semitendinosus m.

Gluteus maximus m.

Sciatic nerve
(Top) Sciatic nerve lies between quadratus femoris muscle and gluteus maximus muscle. The tensor fascia lata and sartorius muscles are
on a divergent course heading laterally and medially, respectively. (Middle) The obturator internus and externus muscles are seen on
the inner and outer surfaces of the obturator foramen. The obturator membrane separates the muscles. The iliopsoas muscle is
tapering toward its insertion onto the lesser trochanter. The gluteus maximus muscle continues its wide coverage of the inferior aspect
of the buttocks. (Bottom) The semimembranosus muscle originates from the external surface of the ischial tuberosity, anterior to the
conjoined origin of the semitendinous and long head of the biceps femoris muscles. The adductor brevis muscles lie deep to the
pectineus muscle.

618


Thigh Radiographic Anatomy and MR Atlas
Thigh

AXIAL T1 MR, UPPER LEFT THIGH
Common femoral artery, vein and nerve
Rectus abdominis m.
Iliopsoas muscle
Pectineus muscle
Rectus femoris m.
Acetabular fossa

Tensor fascia lata m.

Obturator externus m.
Ischium
Iliotibial band
Obturator internus m.
Sciatic n.

Gluteus medius t.
Vastus lateralis m.
Quadratus femoris m.

Gluteus maximus m.

Sartorius m.
Common femoral artery & vein
Pectineus m.
Iliopsoas m.
Adductor brevis m.
Obturator externus m.
Obturator internus m.

Ischium
Semimembranosus t.
Conjoined origin long head of biceps
femoris and semitendinosus ms.
Sciatic n.
Gluteus maximus m.

Tensor fascia lata m.

Iliotibial band
Gluteus medius t.
Vastus lateralis m.
Rectus femoris m.
Quadratus femoris m.

Sartorius muscle
Adductor longus aponeurosis
Common femoral a., v.
Pectineus muscle
Adductor brevis m.
Obturator externus m.
Obturator internus m.
Ischial tuberosity
Semimembranosus t.

Iliotibial band

Gluteus medius t.
Conjoined origin long head of biceps
femoris m. & semitendinosus m.

Sciatic n.
Gluteus maximus m.

Vastus lateralis m.
Iliopsoas muscle
Quadratus femoris m.

(Top) Sciatic nerve lies between quadratus femoris muscle and gluteus maximus muscle. The tensor fascia lata and sartorius muscles are
on a divergent course heading laterally and medially, respectively. (Middle) The obturator internus and externus muscles are seen on
the inner and outer surfaces of the obturator foramen. The obturator membrane separates the muscles. The iliopsoas muscle tapers
toward its insertion onto the lesser trochanter. The gluteus maximus muscle continues its wide coverage of the inferior aspect of the
buttocks. (Bottom) The semimembranosus muscle originates from the external surface of the ischial tuberosity, anterior to the
conjoined origin of the semitendinous and long head of the biceps femoris muscles. The adductor brevis muscles lies deep to the
pectineus muscle.

619


Thigh

Thigh Radiographic Anatomy and MR Atlas

AXIAL T1 MR, UPPER RIGHT THIGH
Sartorius muscle
Greater saphenous v.

Tensor fascia lata m.

Iliotibial band
Vastus lateralis m.

Rectus femoris m.
Quadratus femoris m.
Iliopsoas m.

Common femoral n., a., v.
Adductor brevis m.
Pectineus m.
Obturator externus m.
Obturator internus m.
Ischial tuberosity
Semimembranosus t.
Conjoined origin long head of biceps
femoris m. & semitendinosus m.
Sciatic n.
Gluteus maximus m.

Sartorius m.
Femoral nerve
Adductor longus t.
Common femoral vessels
Pectineus m.
Adductor brevis m.
Iliopsoas m.
Rectus femoris m.

Obturator externus m.

Vastus lateralis m.

Inferior pubic ramus

Vastus medialis m.

Ischial tuberosity

Lateral circumflex femoral artery & vein
Quadratus femoris m.
Sciatic nerve
Gluteus maximus m.
Lesser trochanter

Semimembranosus t.
Semitendinosus t.
Long head biceps t.

Sartorius m.
Femoral nerve
Greater saphenous v.
Common femoral artery & vein
Adductor longus t.
Adductor brevis m.
Lateral circumflex femoral a., v.
Tensor fascia lata m.

Pectineus m.

Rectus femoris m.

Obturator externus m.

Vastus lateralis m.

Iliopsoas m.

Vastus intermedius m.
Sciatic nerve
Gluteus maximus m.

Lesser trochanter
Semimbranosus m.
Biceps, semitendinosus tt.

(Top) The greater saphenous vein is feeding into the common femoral vein. Except for the gluteus maximus muscle, the quadratus
femoris muscle is the most inferior of the external rotators of the hip. (Middle) Pectineus muscle is medial to iliopsoas muscle and will
insert inferior to it on the proximal femoral shaft. Semintendinosis tendon and long head of biceps tendon are starting to diverge at this
point. (Bottom) The vastus lateralis has the most proximal origin of the vasti muscles. The vastus intermedius muscle is now coming into
view. The lateral circumflex femoral artery courses deep to the sartorius and rectus femoris muscles.

620


Thigh Radiographic Anatomy and MR Atlas
Thigh

AXIAL T1 MR, UPPER LEFT THIGH
Sartorius muscle
Greater saphenous v.
Common femoral a., v., n.
Adductor brevis m.
Pectineus m.

Obturator externus m.
Obturator internus m.

Iliotibial band
Tensor fascia lata m.

Ischial tuberosity
Gluteus medius t.
Semimembranosus t.
Conjoined origin long head biceps
femoris m. & semitendinosus m.
Gluteus maximus m.

Vastus lateralis m.
Quadratus femoris m.
Iliopsoas muscle

Sciatic n.
Common femoral artery & vein
Greater saphenous v.
Adductor longus t.
Pectineus muscle
Adductor brevis m.
Iliopsoas muscle
Obturator externus m.
Inferior ramus
Ischial tuberosity

Iliotibial band
Rectus femoris m.

Vastus lateralis m.
Lateral circumflex a., v.

Lesser trochanter
Semimembranosus t.
Conjoined origin long head biceps
femoris m. & semitendinosus m.

Quadratus femoris m.
Sciatic nerve
Gluteus maximus m.

Common femoral artery & vein
Greater saphenous v.
Adductor longus t.
Adductor brevis m.
Pectineus muscle
Obturator externus m.
Inferior (ischiopubic) ramus
Lesser trochanter
Semimembranosus t.
Conjoined origin long head biceps
femoris m. & semitendinosus m.
Sciatic n.
Gluteus maximus m.

Tensor fascia lata m.
Vastus lateralis m.
Sartorius m.
Rectus femoris m.

Lateral circumflex femoral a., v.
Iliopsoas muscle
Quadratus femoris m.

(Top) The greater saphenous vein is feeding into the common femoral vein. The gluteus medius tendon has its insertion along the lateral
facet of the greater trochanter. Except for the gluteus maximus muscle, the quadratus femoris muscle is the most inferior of the
external rotators of the hip and is recognized by its horizontal orientation deep to the gluteus maximus muscle. (Middle) Pectineus
muscle is medial to the iliopsoas muscle and will insert inferior to it on the proximal femoral shaft. Semintendinosis tendon and long
head biceps tendon are starting to diverge at this point. (Bottom) The vastus lateralis has the most proximal origin of the vasti muscles.
The vastus intermedius muscle is now coming into view. The lateral circumflex femoral artery courses deep to the sartorius and rectus
femoris muscles.

621


Thigh

Thigh Radiographic Anatomy and MR Atlas

AXIAL T1 MR, UPPER RIGHT THIGH
Femoral nerve
Common femoral artery & vein
Greater saphenous v.
Adductor longus m.

Tensor fascia lata m.
Rectus femoris m.
Iliotibial band
Vastus lateralis m.
Vastus intermedius m.

Vastus medialis m.
Quadratus femoris m.

Adductor brevis m.
Pectineus muscle
Gracilis tendon
Adductor magnus m.
Semimembranosus t.
Semitendinosus m.
Biceps femoris t., long head
Sciatic n.
Gluteus maximus m.

Rectus femoris m.
Sartorius m.
Adductor longus m.
Adductor brevis m.
Common femoral a., v.

Iliotibial band
Vastus lateralis m.
Vastus intermedius m.
Linea aspera
Vastus medialis m.
Sciatic nerve

Gracilis muscle
Pectineus muscle
Adductor minimus
Adductor magnus m.

Semimembranosus t.
Long head biceps m.
Semitendinosus m.
Gluteus maximus m.

Sartorius muscle
Rectus femoris m.
Tensor fascia lata m.
Adductor longus m.

Vastus intermedius m.
Vastus lateralis m.
Gluteus maximus insertion on iliotibial
band
Iliopsoas m.
Sciatic nerve
Long head biceps femoris m.
Gluteus maximus m.

Adductor brevis m.
Gracilis muscle
Vastus medialis m.
Pectineus muscle
Adductor magnus m.
Adductor minimus m.
Semimembranosus t.
Semitendinosus m.

(Top) All 4 of the quadriceps muscles are now visible, with the vastus intermedius and medialis still quite small. This is the most inferior
image on which the femoral nerve can be identified. It branches entirely within the femoral triangle. The 2 origins of the adductor

magnus muscle are visible. The more anterior adductor portion (a.k.a. adductor minimus) originates from the inferior pubic ramus, and
the more posterior portion of the muscle originates from the ischial tuberosity. (Middle) The changing orientation between the
semimembranosus and the other hamstring tendons continues. The semimembranosus tendon is now more medially positioned. These
are the first images on which the thin gracilis tendon is distinctly visible. It is visually merged with other structures above this level.
(Bottom) The gluteus maximus inserts on the iliotibial band and on the gluteal ridge of the femur, the superolateral portion of the linea
aspera. The adductor minimus is the most superior portion of the adductor magnus. It inserts adjacent to the gluteus maximus.

622


Thigh Radiographic Anatomy and MR Atlas
Thigh

AXIAL T1 MR, UPPER LEFT THIGH
Femoral nerve
Common femoral artery & vein
Greater saphenous v.
Adductor longus m.
Adductor brevis m.
Pectineus muscle
Gracilis tendon
Adductor magnus m.
Semimembranosus t.
Semitendinosus m.

Biceps femoris m.
Gluteus maximus m.

Tensor fascia lata m.
Rectus femoris m.

Iliotibial band
Vastus lateralis m.
Vastus medialis m.
Quadratus femoris m.
Sciatic nerve

Rectus femoris m.
Sartorius m.
Greater saphenous v.
Adductor longus m.
Common femoral artery & vein
Adductor brevis m.
Gracilis muscle
Pectineus muscle
Adductor minimus
Adductor magnus
Semimembranosus t.
Semitendinosus m.
Biceps femoris m.

Tensor fascia lata m.
Vastus lateralis m.
Vastus medialis m.
Quadratus femoris m.
Sciatic nerve
Gluteus maximus m.

Rectus femoris m.
Sartorius muscle

Greater saphenous v.
Adductor longus m.
Common femoral a., v.
Adductor brevis m.
Pectineus muscle
Gracilis muscle
Adductor magnus m.
Semimembranosus t.
Semitendinosus m.

Vastus lateralis m.
Vastus medialis m.
Iliopsoas m.
Adductor magnus m. (adductor minimus)

Gluteus maximus m.

Sciatic nerve
Long head, biceps femoris m.

(Top) All 4 of the quadriceps muscles are now visible, with the vastus intermedius and medialis still quite small. This is the most inferior
image on which the femoral nerve can be identified. It branches entirely within the femoral triangle. The 2 origins of the adductor
magnus muscle are visible. The more anterior adductor portion (a.k.a. adductor minimus) originates from the inferior pubic ramus, the
more posterior portion of the muscle originates from the ischial tuberosity. (Middle) The changing orientation between the
semimembranosus and the other hamstring tendons continues. The semimembranosus tendon is now more medially positioned. These
are the first images on which the thin gracilis tendon is distinctly visible. It is visually merged with other structures above this level.
(Bottom) The gluteus maximus inserts on the iliotibial band and on the gluteal ridge of the femur, the superolateral portion of the linea
aspera. The adductor minimus is the most superior portion of the adductor magnus. It inserts adjacent to the gluteus maximus.

623

Thigh

Thigh Radiographic Anatomy and MR Atlas

AXIAL T1 MR, UPPER RIGHT THIGH
Sartorius muscle
Superficial femoral artery & vein
Greater saphenous v.
Adductor longus m.
Deep femoral a., v.
Vastus medialis m.
Tensor fascia lata m.
Vastus lateralis m.
Vastus intermedius
Gluteus maximus insertion
Sciatic nerve
Long head, biceps femoris m.

Adductor brevis m.
Gracilis muscle
Pectineus muscle
Adductor magnus m. (adductor)
Adductor magnus m. (ischiocondylar)
Semimembranosus t.
Semitendinosus m.
Gluteus maximus m.

Rectus femoris m.

Sartorius muscle
Greater saphenous v.
Superficial femoral a., v.
Adductor longus m.
Iliotibial band
Vastus lateralis m.

Deep femoral a., v.

Vastus intermedius m.

Adductor brevis m.

Vastus medialis m.
Femur
Pectineus m.
Sciatic nerve
Long head biceps femoris m.
Gluteus maximus m.

Gracilis muscle

Adductor magnus m.
Semimembranosus t.
Semitendinosus m.

Rectus femoris m.
Sartorius muscle
Greater saphenous v.
Superficial femoral artery & vein

Adductor longus m.
Deep femoral a., v.
Vastus intermedius m.
Iliotibial band
Vastus lateralis m.
Linea aspera of femur
Gluteus maximus insertion
Perforating vessels
Sciatic nerve
Long head biceps femoris m.

Gracilis muscle
Pectineus m.
Adductor brevis m.
Vastus medialis m.
Adductor magnus m.
Semimembranosus t.
Semitendinosus m.
Gluteus maximus m.

(Top) The common femoral vessels have divided into superficial and deep femoral vessels. The gracilis muscle is now visible. The tensor
fascia lata muscle has assumed a more flattened profile. The sciatic nerve lies deep to the biceps femoris muscle. (Middle) The adductor
magnus is a large muscle with multiple components. The most medial portion is called the ischiocondylar portion and attaches to the
adductor tubercle of the medial femoral epicondyle. (Bottom) A large perforating artery is visible. It is a branch of the deep femoral
artery. The tensor fascia lata muscle has completely inserted onto the iliotibial band. Throughout the thigh, the sciatic nerve resides
deep to the biceps femoris muscle.

624

Thigh Radiographic Anatomy and MR Atlas
Thigh

AXIAL T1 MR, UPPER LEFT THIGH
Sartorius muscle
Greater saphenous v.
Superficial femoral artery & vein
Adductor longus m.
Deep femoral a., v.
Adductor brevis m.
Gracilis muscle
Pectineus muscle
Adductor magnus m., (ischiocondylar)
Semimembranosus t.
Semitendinosus m.

Tensor fascia lata m.
Iliotibial band
Vastus lateralis m.
Vastus medialis m.
Sciatic nerve
Adductor magnus m., (adductor)

Gluteus maximus m.

Long head, biceps femoris m.

Rectus femoris m.
Sartorius muscle
Greater saphenous v.

Superficial femoral artery & vein
Adductor longus m.
Deep femoral a., v.
Adductor brevis m.
Gracilis muscle
Adductor magnus m.
Semimembranosus t.
Semitendinosus m.

Gluteus maximus m.

Vastus lateralis m.
Iliotibial band
Femur
Vastus medialis m.
Sciatic nerve
Long head biceps femoris m.

Rectus femoris m.
Sartorius muscle
Greater saphenous v.
Superficial femoral artery & vein
Adductor longus m.
Deep femoral a., v.
Adductor brevis m.
Gracilis muscle
Adductor magnus m.
Semimembranosus t.

Iliotibial band

Vastus medialis m.
Perforating vessels

Semitendinosus m.

Insertion, gluteus maximus m.

Gluteus maximus m.

Sciatic nerve
Long head, biceps femoris m.
Gluteus maximus m.

(Top) The common femoral vessels have divided into superficial and deep femoral vessels. The gracilis muscle is now visible. The tensor
fascia lata muscle has assumed a more flattened profile. Sciatic nerve lies deep to the biceps femoris muscle. (Middle) The adductor
magnus is a large muscle with multiple components. The most medial portion is called the ischiocondylar portion and attaches to the
adductor tubercle of the medial femoral epicondyle. (Bottom) A large perforating artery is visible. It is a branch of the deep femoral
artery. The tensor fascia lata muscle has completely inserted onto the iliotibial band. Throughout the thigh, the sciatic nerve resides
deep to the biceps femoris muscle.

625


Thigh

Thigh Radiographic Anatomy and MR Atlas

AXIAL T1 MR, RIGHT MID THIGH
Rectus femoris m.
Vastus medialis m.

Sartorius m.
Superficial femoral a., v.
Adductor longus m.
Deep femoral a., v.
Vastus lateralis m.
Intermedius m.
Iliotibial band
Vastus lateralis m.
Sciatic nerve
Long head, biceps femoris m.

Gracilis muscle
Adductor brevis m.
Adductor magnus m.
Semimembranosus t.
Semitendinosus m.
Gluteus maximus m.

Rectus femoris m.
Vastus medialis m.
Sartorius muscle
Greater saphenous v.
Superficial femoral a., v.

Vastus intermedius m.
Vastus lateralis m.
Iliotibial band
Gluteus maximus insertion
Long head, biceps femoris m.

Adductor longus m.
Deep femoral a., v.
Adductor brevis m.
Gracilis muscle
Adductor magnus m.
Semimembranosus t.
Semitendinosus m.
Sciatic n.

Gluteus maximus m.

Rectus femoris m.
Sartorius muscle
Greater saphenous v.
Iliotibial band
Vastus intermedius m.
Vastus medialis m.
Vastus lateralis m.
Femur
Sciatic nerve
Long head, biceps femoris m.
Gluteus maximus m.

Superficial femoral artery & vein
Adductor longus m.
Deep femoral a., v.
Gracilis muscle
Adductor brevis m.
Adductor magnus m.
Semimembranosus t.

Semitendinosus m.

(Top) Differentiation of the vastus muscles is difficult in the mid thigh. Incomplete fat planes partially separate the muscles. The vastus
lateralis wraps around the anterior margin of the vastus intermedius. (Middle) The gluteus maximus has a broad insertion on the
iliotibial band and the gluteal tuberosity, a prominence at the superolateral aspect of the linea aspera of the femur. (Bottom) The
semitendinosus muscle belly enlarges through the mid thigh. The muscle bellies of the semimembranosus and semitendinosus muscle
share a reciprocal relationship. As the semitendinosus muscle becomes smaller along its inferior extent, the semimembranosus muscle
becomes larger.

626


Thigh Radiographic Anatomy and MR Atlas
Thigh

AXIAL T1 MR, LEFT MID THIGH
Rectus femoris m.
Sartorius m.
Superficial femoral a., v.
Adductor longus m.
Vastus intermedius m.
Gracilis muscle
Deep femoral a., v.
Semimembranosus t.

Vastus lateralis m.
Vastus intermedius m.
Sciatic n.

Semitendinosus m.

Long head, biceps femoris m.
Gluteus maximus m.

Rectus femoris m.
Sartorius muscle
Superficial femoral artery & vein
Greater saphenous v.
Adductor longus m.
Deep femoral a., v.
Adductor brevis m.
Gracilis muscle
Adductor magnus m.
Semimembranosus t.
Semitendinosus m.

Vastus lateralis m.
Vastus intermedius m.
Vastus medialis m.
Iliotibial band
Sciatic nerve
Gluteus maximus m.
Long head, biceps femoris m.

Sartorius m.
Superficial femoral a., v.
Greater saphenous v.
Adductor longus m.
Deep femoral a., v.
Adductor brevis m.
Gracilis muscle

Adductor magnus m.

Vastus lateralis m.
Vastus intermedius m.

Semimembranosus t.

Vastus medialis m.

Semitendinosus m.
Gluteus maximus m.

Femur
Sciatic nerve
Long head, biceps femoris m.

(Top) Differentiation of the vastus muscles is difficult in the mid thigh. Incomplete fat planes partially separate the muscles. The vastus
lateralis wraps around the anterior margin of the vastus intermedius. (Middle) The gluteus maximus has a broad insertion on the
iliotibial band and the gluteal tuberosity, a prominence at the superolateral aspect of the linea aspera of the femur. (Bottom) The
semitendinosus muscle belly enlarges through the mid thigh. The muscle bellies of the semimembranosus and semitendinosus muscle
share a reciprocal relationship. As the semitendinosus muscle becomes smaller along its inferior extent, the semimembranosus muscle
becomes larger.

627


Thigh

Thigh Radiographic Anatomy and MR Atlas

AXIAL T1 MR, RIGHT MID THIGH
Rectus femoris m.
Sartorius muscle
Saphenous n.

Vastus lateralis m.
Vastus intermedius m.
Vastus medialis m.
Linea aspera of femur
Long head, biceps femoris m.

Superficial femoral artery & vein
Adductor longus m.
Adductor brevis m.
Deep femoral a., v.
Gracilis muscle
Adductor magnus m.
Semimembranosus t.
Sciatic n.
Semitendinosus m.
Gluteus maximus m.

Gluteus maximus m.

Rectus femoris m.
Vastus medialis m.
Sartorius muscle
Vastus intermedius m.
Superficial femoral artery & vein
Adductor longus m.

Iliotibial band
Vastus lateralis m.
Femur
Adductor brevis m.
Sciatic nerve

Deep femoral a., v.
Gracilis muscle
Adductor magnus m.
Semimembranosus t.
Semitendinosus m.

Long head, biceps femoris m.

Rectus femoris m.
Vastus medialis m.
Sartorius muscle
Superficial femoral a., v.
Vastus intermedius m.
Adductor longus m.
Adductor brevis m.
Gracilis muscle
Vastus lateralis m.

Adductor magnus m.

Deep femoral a., v.

Semimembranosus t.
Semitendinosus m.

Sciatic n.
Long head, biceps femoris m.

(Top) The saphenous nerve is the largest cutaneous branch of the femoral nerve. It lies in front of the femoral vessels at this level; more
inferiorly, it moves medially and becomes subcutaneous, accompanying the saphenous vein. (Middle) The vastus lateralis is broad and
covers the vastus intermedius. The gracilis muscle has a band-like configuration and moves slightly posteriorly as it descends caudally.
(Bottom) The adductor magnus is the largest mid-thigh muscle. The semimembranosus tendon is thin and starting to course medially.
Although its tendon originates anterior and lateral to the semitendinosus tendon, the semimembranosus muscle will lie medial to the
semitendinosus muscle in the mid thigh. It returns anterior to the semitendinosus tendon in the distal thigh.

628


Thigh Radiographic Anatomy and MR Atlas
Thigh

AXIAL T1 MR, LEFT MID THIGH
Rectus femoris m.
Sartorius muscle
Superficial femoral artery & vein
Greater saphenous v.
Adductor longus m.
Adductor brevis m.
Gracilis muscle
Adductor magnus m.
Semimembranosus t.
Semitendinosus m.
Long head, biceps femoris m.

Vastus lateralis m.
Vastus intermedius m.
Vastus medialis m.
Linea aspera of femur
Deep femoral a., v.
Sciatic nerve

Gluteus maximus m.

Rectus femoris m.
Sartorius muscle
Superficial femoral artery & vein
Greater saphenous v.
Vastus medialis m.
Adductor longus m.
Adductor brevis m
Gracilis muscle

Vastus lateralis m.
Vastus intermedius m.
Femur
Deep femoral a., v.

Adductor magnus m.
Semimembranosus t.
Semitendinosus m.

Sciatic nerve
Long head, biceps femoris m.

Rectus femoris m.
Sartorius muscle
Superficial femoral artery & vein
Adductor longus m.
Greater saphenous v.
Vastus medialis m.
Adductor brevis m.
Deep femoral a., v.
Gracilis muscle
Adductor magnus m.

Vastus lateralis m.
Vastus intermedius m.
Adductor brevis m.
Sciatic nerve

Semimembranosus t.
Semitendinosus m.

Long head, biceps femoris m.

(Top) The saphenous nerve is the largest cutaneous branch of the femoral nerve. It lies in front of the femoral vessels at this level; more
inferiorly, it moves medially and becomes subcutaneous, accompanying the saphenous vein. (Middle) The vastus lateralis is broad and
covers the vastus intermedius. The gracilis muscle has a band-like configuration and moves slightly posteriorly as it descends caudally.
(Bottom) The adductor magnus is the largest mid-thigh muscle. The semimembranosus tendon is thin and starting to course medially.
Although its tendon originates anterior and lateral to the semitendinosus tendon, the semimembranosus muscle will lie medial to the
semitendinosus muscle in the mid thigh. It returns anterior to the semitendinosus tendon in the distal thigh.

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