Simultaneous bilateral quadriceps tendon rupture: A case report and subject review
Both unilateral and simultaneous bilateral rupture of the quadriceps tendon are frequently misdiagnosed. Patients typically present to the emergency department after a fall associated with sudden sharp pain and inability to extend the knee. Most frequently, the patient is elderly. Those under age 40...
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Published in | The Journal of emergency medicine Vol. 5; no. 6; pp. 481 - 485 |
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Main Authors | , |
Format | Journal Article |
Language | English |
Published |
New York, NY
Elsevier Inc
01.11.1987
Elsevier |
Subjects | |
Online Access | Get full text |
ISSN | 0736-4679 2352-5029 |
DOI | 10.1016/0736-4679(87)90210-1 |
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Abstract | Both unilateral and simultaneous bilateral rupture of the quadriceps tendon are frequently misdiagnosed. Patients typically present to the emergency department after a fall associated with sudden sharp pain and inability to extend the knee. Most frequently, the patient is elderly. Those under age 40 with bilateral quadriceps rupture usually have an associated metabolic disorder. The 22-year-old uremic patient we report is the youngest case with simultaneous bilateral rupture of the quadriceps tendon described in the English literature. Emphasis is placed on the initial clinical presentation and management. In addition, the pathophysiology and differential diagnosis are reviewed. |
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AbstractList | Both unilateral and simultaneous bilateral rupture of the quadriceps tendon are frequently misdiagnosed. Patients typically present to the emergency department after a fall associated with sudden sharp pain and inability to extend the knee. Most frequently, the patient is elderly. Those under age 40 with bilateral quadriceps rupture usually have an associated metabolic disorder. The 22-year-old uremic patient we report is the youngest case with simultaneous bilateral rupture of the quadriceps tendon described in the English literature. Emphasis is placed on the initial clinical presentation and management. In addition, the pathophysiology and differential diagnosis are reviewed.Both unilateral and simultaneous bilateral rupture of the quadriceps tendon are frequently misdiagnosed. Patients typically present to the emergency department after a fall associated with sudden sharp pain and inability to extend the knee. Most frequently, the patient is elderly. Those under age 40 with bilateral quadriceps rupture usually have an associated metabolic disorder. The 22-year-old uremic patient we report is the youngest case with simultaneous bilateral rupture of the quadriceps tendon described in the English literature. Emphasis is placed on the initial clinical presentation and management. In addition, the pathophysiology and differential diagnosis are reviewed. Both unilateral and simultaneous bilateral rupture of the quadriceps tendon are frequently misdiagnosed. Patients typically present to the emergency department after a fall associated with sudden sharp pain and inability to extend the knee. Most frequently, the patient is elderly. Those under age 40 with bilateral quadriceps rupture usually have an associated metabolic disorder. The 22-year-old uremic patient we report is the youngest case with simultaneous bilateral rupture of the quadriceps tendon described in the English literature. Emphasis is placed on the initial clinical presentation and management. In addition, the pathophysiology and differential diagnosis are reviewed. |
Author | Anderson, Gail V. Stephens, Brian O. |
Author_xml | – sequence: 1 givenname: Brian O. surname: Stephens fullname: Stephens, Brian O. organization: Department of Orthopaedic Surgery Department of Community Health, Emory University School of Medicine, Grady Memorial Hospital, Atlanta, Georgia, USA – sequence: 2 givenname: Gail V. surname: Anderson fullname: Anderson, Gail V. organization: Division of Emergency Medicine, Department of Community Health, Emory University School of Medicine, Grady Memorial Hospital, Atlanta, Georgia, USA |
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Cites_doi | 10.2106/00004623-197557060-00024 10.1056/NEJM196205102661903 10.1001/jama.1964.03060220033010 10.1001/jama.1950.62920080001006 10.1302/0301-620X.66B1.6693484 10.1159/000181394 10.1259/0007-1285-56-672-915 10.1016/0002-9610(49)90317-7 10.1038/ki.1973.89 10.2106/00004623-198163060-00010 10.1136/ard.33.5.428 10.1177/036354658301100614 10.1136/bmj.2.5526.1370 |
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Keywords | simultaneous bilateral quadriceps rupture tendon rupture chronic renal failure Human Chronic Urinary system disease Concurrent Renal failure Tissue rupture Diseases of the osteoarticular system Quadriceps muscle Bilateral Tendon |
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References | Dalal, Whittam (BIB4) 1966; 2 Siwek, Rao (BIB7) 1978; 131 Roberts (BIB20) 1984 Preston, Adicoff (BIB3) 1962 Steiner, Palmer (BIB1) 1949; 78 Grenier, Guimont (BIB8) 1983; 11 Avioli (BIB18) 1973; 4 Siwek, Rao (BIB21) 1981; 63A Ramsey, Muller (BIB5) 1970; 70 Levy, Seelendreund, Maor (BIB6) 1970; 53B Morein, Goldschmidt, Pamker (BIB14) 1977; 124 Lavalle, Aparicio, Moreno (BIB10) 1985; 12 MacEachern, Plewes (BIB9) 1984; 66B Lotem, Bernheim, Conforty (BIB13) 1978; 21 Cirincione, Baker (BIB12) 1975; 57A Meneghello, Bertoli (BIB15) 1983; 56 Wetzler, Merkow (BIB2) 1950; 144 Larson, Jones (BIB11) 1984 Lotem, Robson, Rosenfeld (BIB16) 1974; 33 Hohl (BIB19) 1984 Finlayson, Smith, Moore (BIB17) 1964; 187 Finlayson (10.1016/0736-4679(87)90210-1_BIB17) 1964; 187 Siwek (10.1016/0736-4679(87)90210-1_BIB7) 1978; 131 Avioli (10.1016/0736-4679(87)90210-1_BIB18) 1973; 4 Cirincione (10.1016/0736-4679(87)90210-1_BIB12) 1975; 57A Lotem (10.1016/0736-4679(87)90210-1_BIB13) 1978; 21 Grenier (10.1016/0736-4679(87)90210-1_BIB8) 1983; 11 MacEachern (10.1016/0736-4679(87)90210-1_BIB9) 1984; 66B Larson (10.1016/0736-4679(87)90210-1_BIB11) 1984 Hohl (10.1016/0736-4679(87)90210-1_BIB19) 1984 Morein (10.1016/0736-4679(87)90210-1_BIB14) 1977; 124 Ramsey (10.1016/0736-4679(87)90210-1_BIB5) 1970; 70 Roberts (10.1016/0736-4679(87)90210-1_BIB20) 1984 Dalal (10.1016/0736-4679(87)90210-1_BIB4) 1966; 2 Lotem (10.1016/0736-4679(87)90210-1_BIB16) 1974; 33 Wetzler (10.1016/0736-4679(87)90210-1_BIB2) 1950; 144 Siwek (10.1016/0736-4679(87)90210-1_BIB21) 1981; 63A Lavalle (10.1016/0736-4679(87)90210-1_BIB10) 1985; 12 Meneghello (10.1016/0736-4679(87)90210-1_BIB15) 1983; 56 Steiner (10.1016/0736-4679(87)90210-1_BIB1) 1949; 78 Levy (10.1016/0736-4679(87)90210-1_BIB6) 1970; 53B Preston (10.1016/0736-4679(87)90210-1_BIB3) 1962 |
References_xml | – volume: 78 start-page: 752 year: 1949 end-page: 755 ident: BIB1 article-title: Simultaneous bilateral rupture of the quadriceps tendon publication-title: Am J Surg – volume: 66B start-page: 81 year: 1984 end-page: 83 ident: BIB9 article-title: Bilateral simultaneous spontaneous rupture of the quadriceps tendons publication-title: J Bone Joint Surg – volume: 21 start-page: 201 year: 1978 end-page: 208 ident: BIB13 article-title: Spontaneous rupture of tendons. A complication of hemodialyzed patients treated for renal failure publication-title: Nephron – volume: 144 start-page: 615 year: 1950 end-page: 617 ident: BIB2 article-title: Bilateral, simultaneous and spontaneous rupture of the quadriceps tendon publication-title: JAMA – volume: 63A start-page: 932 year: 1981 end-page: 937 ident: BIB21 article-title: Ruptures of the extensor mechanism of the knee joint publication-title: J Bone Joint Surg – volume: 187 start-page: 659 year: 1964 ident: BIB17 article-title: Effects of chronic acidosis on connective tissue publication-title: JAMA – start-page: 968 year: 1962 end-page: 971 ident: BIB3 article-title: Hyperparathyroidism with avulsions of three major tendons: Report of a case publication-title: N Engl J Med – volume: 33 start-page: 428 year: 1974 ident: BIB16 article-title: Spontaneous rupture of the quadriceps tendon in patients on chronic hemodialysis publication-title: Ann Rheum Dis – volume: 12 start-page: 596 year: 1985 end-page: 598 ident: BIB10 article-title: Bilateral avulsion of quadriceps tendons in primary hyperparathyroidism publication-title: J Rheumatol – volume: 56 start-page: 915 year: 1983 end-page: 920 ident: BIB15 article-title: Tendon disease and adjacent bone erosion in dialysis patients publication-title: Br J Radiol – volume: 57A start-page: 852 year: 1975 end-page: 853 ident: BIB12 article-title: Tendon ruptures with secondary hyperparathyroidism publication-title: J Bone Joint Surg – volume: 2 start-page: 1370 year: 1966 ident: BIB4 article-title: Bilateral simultaneous rupture of the quadriceps tendon publication-title: Br Med J – volume: 70 start-page: 161 year: 1970 end-page: 164 ident: BIB5 article-title: Quadriceps tendon rupture: A diagnostic trap publication-title: Clin Orthop – volume: 11 start-page: 451 year: 1983 end-page: 453 ident: BIB8 article-title: Simultaneous bilateral rupture of the quadriceps tendon and leg fractures in a weight lifter publication-title: Am J Sports Med – volume: 4 start-page: 105 year: 1973 end-page: 115 ident: BIB18 article-title: Collagen metabolism, uremia and bone publication-title: Kid Intern – start-page: 1429 year: 1984 end-page: 1479 ident: BIB19 article-title: Fractures about the knee publication-title: Fractures in Adults – volume: 124 start-page: 209 year: 1977 end-page: 214 ident: BIB14 article-title: Spontaneous tendon ruptures in patients treated by chronic hemodialysis publication-title: Clin Orthop – start-page: 927 year: 1984 end-page: 936 ident: BIB20 article-title: Fractures and dislocations of the knee publication-title: Fractures in Children – volume: 53B start-page: 510 year: 1970 end-page: 513 ident: BIB6 article-title: Bilateral spontaneous and simultaneous rupture of the quadriceps tendons in gout publication-title: J Bone Joint Surg – start-page: 1480 year: 1984 end-page: 1594 ident: BIB11 article-title: Dislocation and ligamentous injuries of the knee publication-title: Fractures in Adults – volume: 131 start-page: 252 year: 1978 end-page: 254 ident: BIB7 article-title: Bilateral simultaneous rupture of the quadriceps tendons publication-title: Clin Orthop – volume: 57A start-page: 852 year: 1975 ident: 10.1016/0736-4679(87)90210-1_BIB12 article-title: Tendon ruptures with secondary hyperparathyroidism publication-title: J Bone Joint Surg doi: 10.2106/00004623-197557060-00024 – start-page: 968 year: 1962 ident: 10.1016/0736-4679(87)90210-1_BIB3 article-title: Hyperparathyroidism with avulsions of three major tendons: Report of a case publication-title: N Engl J Med doi: 10.1056/NEJM196205102661903 – volume: 131 start-page: 252 year: 1978 ident: 10.1016/0736-4679(87)90210-1_BIB7 article-title: Bilateral simultaneous rupture of the quadriceps tendons publication-title: Clin Orthop – volume: 187 start-page: 659 year: 1964 ident: 10.1016/0736-4679(87)90210-1_BIB17 article-title: Effects of chronic acidosis on connective tissue publication-title: JAMA doi: 10.1001/jama.1964.03060220033010 – volume: 12 start-page: 596 year: 1985 ident: 10.1016/0736-4679(87)90210-1_BIB10 article-title: Bilateral avulsion of quadriceps tendons in primary hyperparathyroidism publication-title: J Rheumatol – volume: 144 start-page: 615 year: 1950 ident: 10.1016/0736-4679(87)90210-1_BIB2 article-title: Bilateral, simultaneous and spontaneous rupture of the quadriceps tendon publication-title: JAMA doi: 10.1001/jama.1950.62920080001006 – volume: 66B start-page: 81 year: 1984 ident: 10.1016/0736-4679(87)90210-1_BIB9 article-title: Bilateral simultaneous spontaneous rupture of the quadriceps tendons publication-title: J Bone Joint Surg doi: 10.1302/0301-620X.66B1.6693484 – volume: 21 start-page: 201 year: 1978 ident: 10.1016/0736-4679(87)90210-1_BIB13 article-title: Spontaneous rupture of tendons. A complication of hemodialyzed patients treated for renal failure publication-title: Nephron doi: 10.1159/000181394 – start-page: 927 year: 1984 ident: 10.1016/0736-4679(87)90210-1_BIB20 article-title: Fractures and dislocations of the knee – volume: 56 start-page: 915 year: 1983 ident: 10.1016/0736-4679(87)90210-1_BIB15 article-title: Tendon disease and adjacent bone erosion in dialysis patients publication-title: Br J Radiol doi: 10.1259/0007-1285-56-672-915 – volume: 78 start-page: 752 year: 1949 ident: 10.1016/0736-4679(87)90210-1_BIB1 article-title: Simultaneous bilateral rupture of the quadriceps tendon publication-title: Am J Surg doi: 10.1016/0002-9610(49)90317-7 – volume: 70 start-page: 161 year: 1970 ident: 10.1016/0736-4679(87)90210-1_BIB5 article-title: Quadriceps tendon rupture: A diagnostic trap publication-title: Clin Orthop – volume: 4 start-page: 105 year: 1973 ident: 10.1016/0736-4679(87)90210-1_BIB18 article-title: Collagen metabolism, uremia and bone publication-title: Kid Intern doi: 10.1038/ki.1973.89 – volume: 63A start-page: 932 year: 1981 ident: 10.1016/0736-4679(87)90210-1_BIB21 article-title: Ruptures of the extensor mechanism of the knee joint publication-title: J Bone Joint Surg doi: 10.2106/00004623-198163060-00010 – volume: 33 start-page: 428 year: 1974 ident: 10.1016/0736-4679(87)90210-1_BIB16 article-title: Spontaneous rupture of the quadriceps tendon in patients on chronic hemodialysis publication-title: Ann Rheum Dis doi: 10.1136/ard.33.5.428 – volume: 124 start-page: 209 year: 1977 ident: 10.1016/0736-4679(87)90210-1_BIB14 article-title: Spontaneous tendon ruptures in patients treated by chronic hemodialysis publication-title: Clin Orthop – volume: 11 start-page: 451 year: 1983 ident: 10.1016/0736-4679(87)90210-1_BIB8 article-title: Simultaneous bilateral rupture of the quadriceps tendon and leg fractures in a weight lifter publication-title: Am J Sports Med doi: 10.1177/036354658301100614 – volume: 53B start-page: 510 year: 1970 ident: 10.1016/0736-4679(87)90210-1_BIB6 article-title: Bilateral spontaneous and simultaneous rupture of the quadriceps tendons in gout publication-title: J Bone Joint Surg – start-page: 1429 year: 1984 ident: 10.1016/0736-4679(87)90210-1_BIB19 article-title: Fractures about the knee – volume: 2 start-page: 1370 year: 1966 ident: 10.1016/0736-4679(87)90210-1_BIB4 article-title: Bilateral simultaneous rupture of the quadriceps tendon publication-title: Br Med J doi: 10.1136/bmj.2.5526.1370 – start-page: 1480 year: 1984 ident: 10.1016/0736-4679(87)90210-1_BIB11 article-title: Dislocation and ligamentous injuries of the knee |
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SubjectTerms | Adult Biological and medical sciences chronic renal failure Diseases of the osteoarticular system Humans Hyperparathyroidism, Secondary - complications Kidney Failure, Chronic - complications Knee Injuries - diagnostic imaging Male Medical sciences Miscellaneous. Osteoarticular involvement in other diseases Radiography simultaneous bilateral quadriceps rupture Tendon Injuries tendon rupture |
Title | Simultaneous bilateral quadriceps tendon rupture: A case report and subject review |
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