Myotendinous Junction: Difference between revisions

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== US and MRI ==
== US and MRI ==
For correct diagnosis and prognosis a grading system of MTJ injuries was created
For correct diagnosis and prognosis a grading system of MTJ injuries was created, for use when using [[MRI Scans|MRI]] or [[Ultrasound Scans|US]] scans.


# Mild [[Muscle Strain|strain]]: feathery interstitial edema and fluid/hemorrhage around the MTJ
# Mild [[Muscle Strain|strain]]: feathery interstitial edema and fluid/hemorrhage around the MTJ

Revision as of 09:36, 12 June 2022

Original Editor - Lucinda hampton

Top Contributors - Lucinda hampton  

Introduction[edit | edit source]

MTJ structure

Myotendinous junction (MTJ) is a part of the myotendinous unit, which connects muscle and tendon, and transmits forces between them (the myotendinous unit consisting usually of bone, enthesis, tendon, myotendinous junction and muscle[1])

The MTJ has a unique morphology with a highly folded muscle membrane filled with invaginations of collagen fibrils from the tendon. This creates an increased area of force transmission between muscle and tendon and, as a result, disperses the energy of a contracting muscle, decreasing focal stress[2][3].

During muscle activity and mainly during high effort exercise, large forces are transmitted from muscle fibers to the tendon through the MTJ. It is a common location for strain injuries in sports. Most of these can be prevented by heavy eccentric exercise[3].

  • In animals, the size and number of foldings are increased as a response to heavy training and reduced during inactivity.
  • In humans, the muscle fibers near the MTJ show very high rates of remodeling compared to other regions of the muscle.

Physiotherapy Implications[edit | edit source]

Dissection of the gastrocnemius–soleus MTJ

In a healthy adult, the MTJ is the weakest region of the myotendinous unit and for that reason it is its most commonly injured part.

  • The highest risk of strain occurs in large pennate muscles that cross two joints and produce large tensile forces e.g. biceps femoris, quadratus femoris, biceps brachii[2].
  • With aging there is shortening of the interdigitations with a resulting decrease in contact area between the sarcolemma and extracellular components.[4]

US and MRI[edit | edit source]

For correct diagnosis and prognosis a grading system of MTJ injuries was created, for use when using MRI or US scans.

  1. Mild strain: feathery interstitial edema and fluid/hemorrhage around the MTJ
  2. Moderate strain: intramuscular hematoma and perifascial fluid/hemorrhage
  3. Severe strain: MTJ tear with laxity/discontinuity of the tendon and muscle ends, sometimes with retraction

Scar tissue, old blood products and atrophy/fatty degeneration of the muscle are indicative of an old strain[2].

References[edit | edit source]

  1. Radiopedia Myotendinous unit Available: https://radiopaedia.org/articles/myotendinous-unit?lang=us(accessed 12.6.2022)
  2. 2.0 2.1 2.2 Radiopedia Myotendinous junction Available:https://radiopaedia.org/articles/myotendinous-junction?lang=us (accessed 12.6.2022)
  3. 3.0 3.1 Jakobsen JR, Krogsgaard MR. The Myotendinous Junction—A Vulnerable Companion in Sports. A Narrative Review. Frontiers in physiology. 2021;12. Available;https://www.frontiersin.org/articles/10.3389/fphys.2021.635561/full (accessed 12.6.2022)
  4. Wikimsk MTJ Available:https://wikimsk.org/wiki/Myotendinous_Junction (accessed 12.6.2022)