Topics

Topic

design image
Distal adductor magnus tendon

The distal adductor magnus tendon is the strong terminal tendon of the hamstring portion of the adductor magnus muscle. It descends in the medial thigh and inserts onto the femur near the knee. This tendon forms an important anatomical landmark, as it lies adjacent to the adductor hiatus, through which the femoral vessels pass into the popliteal fossa. It is a site of clinical relevance in knee surgery, radiology, and sports medicine, particularly in cases of tendinopathy, trauma, or surgical reconstruction.

Synonyms

  • Adductor tubercle tendon

  • Hamstring part tendon of adductor magnus

  • Distal tendon of adductor magnus

Origin and Insertion

  • Origin:

    • Continuation of the hamstring (ischial) portion of the adductor magnus, which arises from the ischial tuberosity

  • Course:

    • Fibers run vertically downwards along the medial thigh

    • The tendon becomes distinct in the distal third of the femur

    • Passes just above the medial condyle and adductor hiatus

  • Insertion:

    • Inserts onto the adductor tubercle of the medial femoral condyle

Relations

  • Anteriorly: Femoral vessels as they enter the adductor hiatus

  • Posteriorly: Popliteal vessels in the popliteal fossa

  • Medially: Vastus medialis muscle and medial intermuscular septum

  • Laterally: Distal femur and knee joint capsule

  • Inferiorly: Origin of medial collateral ligament of the knee (arises just distal to adductor tubercle)

Nerve Supply

  • Hamstring part of adductor magnus supplied by the tibial division of the sciatic nerve (L4)

Arterial Supply

  • Perforating branches of profunda femoris artery

  • Femoral artery (distal branches)

  • Genicular arteries around the knee

Venous Drainage

  • Perforating veins into profunda femoris vein

  • Femoral vein

  • Popliteal vein (via genicular tributaries)

Function

  • Provides powerful stabilization of the medial thigh and knee

  • Assists in extension of the thigh (hamstring part)

  • Provides an anchoring point for medial soft tissues near the knee

  • Helps guide femoral vessels through the adductor hiatus

Clinical Significance

  • Landmark in surgical approaches to the distal femur and knee

  • Important in identifying the adductor hiatus and vessel transitions from femoral to popliteal

  • Can be injured in distal adductor strains or medial knee trauma

  • Calcification or enthesopathy at the adductor tubercle may mimic pathology on imaging

  • Relation to medial collateral ligament makes it relevant in ligament reconstruction surgery

MRI Appearance

T1-weighted images:

  • Tendon appears as a low-signal (dark) structure inserting at adductor tubercle

  • Surrounded by bright fat, highlighting margins

T2-weighted images:

  • Tendon remains low signal

  • Partial tear, strain, or enthesitis may show focal bright signal within tendon or at insertion

STIR (Short Tau Inversion Recovery):

  • Normal tendon remains dark

  • Edema, tear, or inflammation shows bright hyperintensity around or within tendon

Proton Density Fat-Saturated (PD FS):

  • Tendon is dark

  • Pathology (strain, tear, bursitis, enthesopathy) shows bright hyperintense changes

T1 Fat-Sat Post-Contrast:

  • Normal tendon shows minimal or no enhancement

  • Pathology shows focal or rim enhancement (tendinopathy, enthesitis, tumor infiltration)

CT Appearance

Non-Contrast CT:

  • Tendon is not directly visualized, seen as a dense band at the adductor tubercle

  • Calcification or ossification at insertion may appear as hyperdense foci

  • Surrounding fat planes improve localization

Post-Contrast CT:

  • Normal tendon does not enhance significantly

  • Pathologic conditions (inflammation, neoplasm) may show enhancement of adjacent soft tissues

  • Bony insertion (adductor tubercle) may show sclerosis or irregularity in chronic enthesopathy

MRI images

Adductor magnus tendon sagittal mri image

MRI images

Adductor magnus tendon

CT images

Distal adductor magnus tendon ct axial image

CT images

Distal adductor magnus tendon sagittal image