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Medial circumflex femoral vein

The medial circumflex femoral vein (MCFV) is a key tributary of the femoral venous system, accompanying the medial circumflex femoral artery. It arises from venous plexuses around the hip joint capsule, adductor muscles, and obturator externus, courses posteriorly and medially around the femur, and drains into the profunda femoris vein (deep femoral vein) or occasionally directly into the femoral vein.

The vein communicates with the obturator vein, inferior gluteal vein, and other pelvic venous plexuses, forming important venous collateral pathways. It is clinically significant in conditions such as deep vein thrombosis (DVT), femoroacetabular pathology, pelvic venous congestion, and orthopedic surgery of the hip joint.

Synonyms

  • Vena circumflexa femoris medialis

  • Medial femoral circumflex vein

Function

  • Provides venous drainage of the hip joint capsule, adductor group, and obturator externus muscle

  • Connects profunda femoris vein to pelvic venous plexuses

  • Contributes to collateral circulation of the hip and thigh

  • Clinical role in DVT, venous obstruction, and orthopedic surgery involving hip approaches

MRI Appearance

T1-weighted images:

  • Vein appears as a linear hypointense lumen alongside medial circumflex femoral artery

  • Surrounded by bright fat, providing natural contrast

T2-weighted images:

  • Flowing blood: signal void

  • Thrombosed lumen: hyperintense or heterogeneous intraluminal signal

  • Adjacent edema: bright signal around vein in inflammation

STIR:

  • Suppresses fat to highlight perivenous edema or inflammation

  • Venous thrombosis: bright hyperintensity around non-visualized lumen

T1 Fat-Suppressed Post-Gadolinium:

  • Normal: uniform bright enhancement of lumen

  • Pathology: non-enhancing filling defect in thrombosis; irregular wall enhancement in phlebitis or tumor encasement

MRV (Magnetic Resonance Venography):

  • Signal: flowing venous blood appears bright hyperintense on contrast-enhanced MRV

  • Thrombosed vein: hypointense, non-enhancing segment

  • Shows full course from profunda femoris to pelvic venous connections

  • Useful for DVT mapping and surgical planning

CT Appearance

Non-contrast CT:

  • Vein not well visualized

  • Appears as a small soft-tissue tubular density near medial femoral neck

CT Post-Contrast:

  • Enhances clearly, visible running with medial circumflex femoral artery

  • Detects venous dilation, compression, or perivenous mass effect

CTV (CT Venography):

  • Signal: enhancing vein appears bright hyperdense

  • Thrombosis: filling defect within lumen, surrounded by enhancing contrast

  • Multiplanar and 3D reconstructions map course and connections to profunda femoris vein and pelvic plexuses

  • Useful for evaluating pelvic DVT, varicosities, and hip venous congestion

CT image

medial circumflex femoral vein CT axial anatomy image-img-00000-00000

CT image

medial circumflex femoral vein CT axial image

MRI image

medial circumflex femoral vein mri axial anatomy image-img-00000-00000