A 7-year-old boy presented with abnormal gait since age 3 years. Examination showed left-sided limping with external rotation. On passive flexion of the knees while the patient lied prone, the left heel could not reach the buttock and the left hip rose up (Video 1). This indicated a positive Ely test indicating limited flexibility of the rectus femoris muscle.¹ Neurological examination was otherwise unremarkable. He had normal skeletal x-rays of both legs. MRI showed fibrosis of the rectus femoris muscle (Figure), which may be idiopathic or related to trauma. The patient had no history of muscle injury thus distant intramuscular injection was suspected to be the cause. Early diagnosis helps improve mobility through early surgical intervention.² Ely test, which is not routinely performed during neurological examination, might be helpful in evaluating children with abnormal gait.

一名 7 岁男孩从 3 岁起就出现步态异常。检查显示左侧跛行并伴有外旋。患者俯卧时膝盖被动屈曲，左脚跟无法到达臀部，左臀部抬起（视频1）。这表明伊利试验呈阳性，表明股直肌灵活性有限。¹神经系统检查未发现其他异常。他的双腿骨骼X光检查结果正常。MRI 显示股直肌纤维化（图），这可能是特发性的或与外伤有关。该患者没有肌肉损伤史，因此怀疑是远处肌肉注射所致。早期诊断有助于通过早期手术干预改善活动能力。² Ely 测试在神经系统检查期间不常规进行，可能有助于评估步态异常的儿童。