Tug lesions on the linea aspera in a cadaver: a case report

The linea aspera is located on the posterior surface of the femur and is composed of longitudinal ridges of bone. The linea aspera serves as the attachment site for the hip adductor muscles, vastus medialis, short head of the biceps femoris, and vastus lateralis. Tug lesions, or cortical bone outgrowth at the site of tendinous insertions, are commonly found in children and adolescents. The bilateral femurs of a 93-year-old donated body were analyzed. Tug lesions were observed on the linea aspera bilaterally; they were then exposed and radiographed. A board-certified radiologist who was blinded to the case read the radiographs and noted several lytic lesions and tug lesion variations. Tug lesions are commonly found at attachment sites for muscles; however, they have not been documented on the linea aspera. While most tug lesions are asymptomatic, they can be symptomatic. Depending on the degree of tug lesion growth, patients may undergo unnecessary testing or procedures to determine the etiology of linea aspera lesion. The purpose of this study was to report this rare anatomic occurrence of tug lesions of the linea aspera.