Rare Variant of Vastus Medialis Detected in vivo by Ultrasound and Confirmed by High-resolution MRI

[Purpose] This report describes an unusual incidental finding during ultrasound investigation of the vastus medialis muscle. Volunteers underwent ultrasound scanning as part of an on-going investigation into the architecture of the vastus medialis muscle. [Subjects and Methods] The distal thighs of forty-one subjects were scanned using the Philips iU22 US system. An unusual muscle morphology was detected bilaterally in one subject, who then underwent a 3T Magnetic Resonance Imaging (MRI) scan in order to further investigate the muscle morphology. The subject in question was a 32 year-old female who suffers from recurrent bilateral patellar dislocations. [Results] The MRI scan confirmed the ultrasound findings, and indicated the presence of the vastus medialis in two layers, with the VML continuing deep, separate from the VMO. [Conclusion] Although this rare variant has been been reported in previous cadaveric studies, we believe this to be the first report in the literature of this morphology in vivo. The biomechanical implications of this muscle arrangement are unknown, but it may not be without significance that this individual suffers from recurrent patellar dislocations.