Quadriceps tendon rupture: Difference between revisions
(Created page with "==Background== *Occurs via forceful contraction of quadriceps muscle or falling on flexed knee *Typically occur 2cm from insertion on patella {{Patellar vs Quadriceps tendon...") |
No edit summary |
||
| Line 8: | Line 8: | ||
*Sudden "pop" or tearing | *Sudden "pop" or tearing | ||
*Diffuse swelling | *Diffuse swelling | ||
*Defect may be palpable above | *Defect may be palpable above the patella | ||
*Partial tears lead to difficulty extending the knee | *Partial tears lead to difficulty extending the knee | ||
*Complete tears lead to absent straight leg raise while supine or extension of the knee again | *Complete tears lead to absent straight leg raise while supine or extension of the knee again | ||
| Line 19: | Line 19: | ||
**Separation of the tendon can be visualized | **Separation of the tendon can be visualized | ||
*X-ray | *X-ray | ||
**Patella baja/infera (low-riding patella) | |||
**Patella baja/infera ( | |||
==Management== | ==Management== | ||
Revision as of 06:09, 5 January 2017
Background
- Occurs via forceful contraction of quadriceps muscle or falling on flexed knee
- Typically occur 2cm from insertion on patella
Patellar vs Quadriceps tendon rupture
| Finding | Patellar tendon rupture | Quadriceps tendon rupture |
| Location | Distal to patella | Proximal to patella |
| Typical group | Patients <40yr with history of tendinitis or steroid injections | Patients >40yr |
| X-ray | Patella alta (high-riding patella) | Patella baja/infera (low-riding patella) |
Clinical Features
- Sudden "pop" or tearing
- Diffuse swelling
- Defect may be palpable above the patella
- Partial tears lead to difficulty extending the knee
- Complete tears lead to absent straight leg raise while supine or extension of the knee again
Differential Diagnosis
Knee diagnoses
Acute knee injury
- Knee dislocation
- Knee fractures
- Meniscus and ligament knee injuries
- Patella dislocation
- Patellar tendonitis
- Patellar tendon rupture
- Quadriceps tendon rupture
Nontraumatic/Subacute
- Arthritis
- Gout and Pseudogout
- Osgood-Schlatter disease
- Patellofemoral syndrome (Runner's Knee)
- Patellar tendonitis (Jumper's knee)
- Pes anserine bursitis
- Popliteal cyst (Bakers cyst)
- Prepatellar bursitis (nonseptic)
- Septic bursitis
- Septic joint
- DVT
Evaluation
- Ultrasound
- Separation of the tendon can be visualized
- X-ray
- Patella baja/infera (low-riding patella)
Management
- Ortho consult in the ED
- Knee immobilizer, can be weight bearing
- Operative repair advised within 7 days
Disposition
See Also
References
- Uptodate
- Wheeless' Textbook of Orthopaedics