Quadriceps tendon tear

Case contributed by Bruno Di Muzio
Diagnosis certain

Presentation

Knee pain and swelling for one day. No traumatic history recalled.

Patient Data

Age: 50-year-old
Gender: Male

Radiographs

x-ray

The left femoral head is well aligned. No definite fracture is identified. Two rice-like calcific foci are seen with apparent surrounding increased density within the soft tissues just superior to the patella, indenting the underlying quadriceps tendon. No further soft tissue calcific foci are seen elsewhere. Appearances are nonspecific. Clinical correlation is recommended. An ultrasound could be helpful in further evaluating this abnormality.

Left knee ultrasound

ultrasound

There is a complete tear of the quadriceps tendon, approximately 4.2 cm above its insertion into the patella. The defect within the tendon extends over a craniocaudal distance of approximately 2.3 cm and is associated with a hematoma. Two small calcific densities, the largest measuring approximately 7 mm lie within the tendon defect. These are better seen on the plain film and although they may represent a avulsed fragments, the tendon at its insertion point is intact, and the densities are corticated on the plain film with a chronic appearance, possibly related to an old injury. 

Case Discussion

This case illustrates a complete tear of the quadriceps tendon.

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