Presentation
Acute knee pain following fall on knee ? fracture
Patient Data
Age: 85 years
Gender: Male
From the case:
Quadriceps tendon rupture
{"current_user":null,"step_through_annotations":true,"access":{"can_edit":false,"can_download":true,"can_toggle_annotations":true,"can_feature":false,"can_examine_pipeline_reports":false,"can_pin":false},"extraPropsURL":"/studies/122896/annotated_viewer_json?iframe=true\u0026lang=us"}
- large volume joint fluid and pre patellar soft tissue swelling
- corticated ossifications anterior to the distal femur are presumably within the quadriceps tendon. These calcifications are located a few centimeters proximal to the patella with findings highly concerning for quadriceps rupture
- no fractures
From the case:
Quadriceps tendon rupture
{"current_user":null,"step_through_annotations":true,"access":{"can_edit":false,"can_download":true,"can_toggle_annotations":true,"can_feature":false,"can_examine_pipeline_reports":false,"can_pin":false},"extraPropsURL":"/studies/123625/annotated_viewer_json?iframe=true\u0026lang=us"}
- hyperdense blood within the suprapatellar recess. The blood extends through an apparent defect within the distal quadriceps tendon
- calcification associated with the distal quadriceps tear where there is tendon retraction
From the case:
Quadriceps tendon rupture
{"current_user":null,"step_through_annotations":true,"access":{"can_edit":false,"can_download":true,"can_toggle_annotations":true,"can_feature":false,"can_examine_pipeline_reports":false,"can_pin":false},"extraPropsURL":"/studies/123626/annotated_viewer_json?iframe=true\u0026lang=us"}
- two anchors within the superior pole of the patella post quadriceps tendon repair
Case Discussion
A quadriceps tendon rupture was suspected on the initial radiograph due to the unusual location of the tendinous calcifications projected anterior to the femur in addition to the large effusion.
The patient likely sustained a forced flexion mechanism during the fall.