Ruptured quadriceps tendon

Case contributed by Dr Craig Hacking

Presentation

Fall onto left knee, now painful and swollen.

Patient Data

Age: 80 years
Gender: Male
X-ray

Marked pre- and supra-patellar soft tissue swelling and there is a joint effusion. No fracture is identified. Increased density in the region of the quadriceps tendon is suspicious of a tendon injury - US is suggested.

Several well-defined irregular calcific foci are projected within the suprapateallar pouch, suggestive of osteochondromatosis.

Ultrasound

Quadriceps tendon rupture with 3.4cm retraction of the tendon. Large heterogeneous 3.5 x 1.2 x 6cm suprapatellar bursal haematoma.

CT

There is extensive fluid superior to the patella, both within the joint space and in the soft tissues or perhaps the bursa. The quadriceps tendon is ill-defined and ruptured, with surrounding haematoma. There is wavy appearance of the patellar ligament. Prepatellar soft tissue swelling noted. Multiple suprapatellar calcified bodies, in keeping with osteochondromatosis.

No tibial, patellar or femoral fracture identified. Degenerative change is noted as well as meniscal calcification (chondrocalcinosis). The femoral attachment of the popliteus is heavily calcified.

Conclusion
Rupture of the quadriceps tendon. No fracture identified.

Case Discussion

The patient was taken to theatre which found an acute on chronic tear, which was repaired.

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Case information

rID: 56032
Case created: 6th Oct 2017
Last edited: 6th Oct 2017
Inclusion in quiz mode: Included

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