Bilateral simultaneous complete quadriceps rupture following chronic symptomatic tendinopathy: a case report

Arumilli, Buchi; Adeyemo, Foley; Samarji, Richard

doi:10.4076/1752-1947-3-9031

Cited by 20 publications

(25 citation statements)

References 10 publications

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“…Steiner and Plamer [1] described the first bilateral quadriceps tendon rupture in 1949 and since then there have been about 100 cases published in the English literature. The rarity of this condition is one of the main reasons for its late and difficult recognition [2] and the false diagnosis of other pathologies, such as neuropathy, cerebrovascular accident and even psychiatric pathologies [1] .…”

Section: Clinical Evidencementioning

confidence: 98%

“…The rarity of this condition is one of the main reasons for its late and difficult recognition [2] and the false diagnosis of other pathologies, such as neuropathy, cerebrovascular accident and even psychiatric pathologies [1] . The three cardinal features of this pathology, as reported by MacEachern in 1984, are bilateral diffuse swellings around the knees, palpable suprapatellar gaps and inability to lift the extended legs, in the presence of normal functioning lower limb muscle groups [2] .…”

Section: Clinical Evidencementioning

confidence: 99%

“…A number of medical pathologies have been associated with this condition, such as chronic kidney disease, diabetes mellitus, hyperparathyroidism, crystal arthropathy, obesity, various connective tissue disorders and chronic tendinopathy [1] . Hyperparathyroidism leads to weakening of the tendon both by calcification and fragility of the bone at the osteotendinous junction [8] .…”

Section: Clinical Evidencementioning

confidence: 99%

“…McMaster [5] demonstrated that for a complete rupture to occur, more than half of the fibres have to be severed. The majority of ruptures occur when quadriceps is eccentrically loaded with the knee in flexion following low-or high-energy falls and direct or indirect injury of the knee [1,3] . Studies have demonstrated that the commonest site of failure is the osteotendinous junction [3] .…”

Section: Clinical Evidencementioning

confidence: 99%

“…Despite this, quadriceps tendon rupture is rather rare even amongst the elderly [3] , with roughly one-third being spontaneous [1,7] .…”

Section: Clinical Evidencementioning

confidence: 99%

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Bilateral quadriceps tendon rupture in a seasoned marathon runner with patellar spurs

Assiotis¹,

Pengas²,

Vemulapalli³

2011

Grand Rounds

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We present the case of a healthy seasoned marathon runner who sustained bilateral quadriceps tendon rupture following a low-energy fall. Radiographs demonstrated bilateral patellar spurs. Our case report serves to highlight the importance of maintaining a high index of clinical suspicion in patients of all ages. This is the first report of bilateral quadriceps rupture in the presence of bilateral patellar spurs. KeywordsQuadriceps tendon rupture; patellar spurs. Case reportA 63-year-old Caucasian gentleman tripped on a step and fell down, landing on both his knees. He felt the sudden onset of severe pain and could not bear weight at all, as his legs were 'giving way'. He presented to an emergency department with gross swelling and bruising around both knees. Plain radiographs were deemed normal and he was sent home with crutches. He spent 6 weeks in bed, as he was unable to bear weight despite the resolving knee swelling and bruising and the significant reduction in pain. He re-attended the emergency department and was reviewed by the orthopaedic team. Clinical examination demonstrated inability to bear weight, inability to raise a straight or initiate knee extension on both sides with tenderness and a 5 cm palpable gap over the superior poles of the patellae. The rest of his lower limb muscles were functioning normally. The clinical diagnosis of bilateral quadriceps tendon rupture was made, supported by radiological evidence, leading to operative treatment the day after.Despite his age, this gentleman had competed more than 40 full marathons in the past 20 years. He was very fit and healthy, with no other health problems, including gout, and was not taking any medication, including steroids or antibiotics. He also denied any pain over the anterior aspect of his knee or distal thigh prior to the injury. His blood tests demonstrated a normal haemoglobin level, normal white cell count and normal renal function and electrolytic profile, including normal calcium and phosphate. His glucose, urate and parathyroid hormone levels were also normal. This paper is available online at http://www.grandrounds-e-med.com. In the event of a change in the URL address, please use the DOI provided to locate the paper.

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Section: Clinical Evidencementioning

confidence: 98%