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Musculoskeletal
Diagnosis
Trauma
Knee
Tendons
Quadriceps Injury
Quadriceps Injury
Kirkland W. Davis, MD, FACR; Andrew Sonin, MD, FACR; Donna G. Blankenbaker, MD, FACR
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Synonyms

              • Quadriceps rupture, quadriceps tear, quad tear

            • Definitions

              • Partial or complete disruption of distal myotendinous units of quadriceps mechanism of thigh
              • Quadriceps tendon: common distal tendon unit for rectus femoris, vastus medialis, vastus intermedius, and vastus lateralis muscles inserting on patella

            IMAGING

            • General Features

              • Radiographic Findings

                • CT Findings

                  • MR Findings

                    • Ultrasonographic Findings

                      • Imaging Recommendations

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            • Staging, Grading, & Classification

                              • Gross Pathologic & Surgical Features

                                CLINICAL ISSUES

                                • Presentation

                                  • Demographics

                                    • Natural History & Prognosis

                                      • Treatment

                                        DIAGNOSTIC CHECKLIST

                                        • Consider

                                          • Image Interpretation Pearls

                                            • Reporting Tips

                                              Selected References

                                              1. Vajapey SP et al: Treatment of extensor tendon disruption after total knee arthroplasty: a systematic review. J Arthroplasty. 34(6):1279-86, 2019
                                              2. Flores DV et al: Layered approach to the anterior knee: normal anatomy and disorders associated with anterior knee pain. Radiographics. 38(7):2069-101, 2018
                                              3. Long JR et al: Postoperative imaging of the knee extensor mechanism. Semin Musculoskelet Radiol. 22(4):424-34, 2018
                                              4. Zribi W et al: Spontaneous and simultaneous complete bilateral rupture of the quadriceps tendon in a patient receiving hemodialysis: a case report and literature review. World J Orthop. 9(9):180-4, 2018
                                              5. McMahon CJ et al: The extensor mechanism: imaging and intervention. Semin Musculoskelet Radiol. 21(2):89-101, 2017
                                              6. Severyns M et al: Arthroscopic suture repair of acute quadriceps tendon ruptures. Orthop Traumatol Surg Res. 103(3):377-80, 2017
                                              7. Zuke WA et al: Quadriceps tendon rupture in an adolescent athlete. Case Rep Orthop. 2017:2718013, 2017
                                              8. Yablon CM et al: Magnetic resonance imaging of the extensor mechanism. Magn Reson Imaging Clin N Am. 22(4):601-20, 2014
                                              9. Lee D et al: Quadriceps and patellar tendon ruptures. J Knee Surg. 26(5):301-8, 2013
                                              10. Hak DJ et al: Quadriceps tendon injuries. Orthopedics. 33(1):40-6, 2010
                                              11. Basic-Jukic N et al: Spontaneous tendon ruptures in patients with end-stage renal disease. Kidney Blood Press Res. 32(1):32-6, 2009
                                              12. Brooks P: Extensor mechanism ruptures. Orthopedics. 32(9), 2009
                                              13. Yun HH et al: Calcific tendinitis of the rectus femoris. Orthopedics. 32(7):490, 2009
                                              14. Bimmel R et al: Quadriceps tendon rupture and periosteal sleeve avulsion fracture of the proximal patella pole in an active adolescent. Orthopedics. 31(7):716, 2008
                                              15. LaRocco BG et al: Ultrasound diagnosis of quadriceps tendon rupture. J Emerg Med. 35(3):293-5, 2008
                                              16. McKinney B et al: Intra-articular knee injuries in patients with knee extensor mechanism ruptures. Knee Surg Sports Traumatol Arthrosc. 16(7):633-8, 2008
                                              17. Pfirrmann CW et al: Quadriceps tendinosis and patellar tendinosis in professional beach volleyball players: sonographic findings in correlation with clinical symptoms. Eur Radiol. 18(8):1703-9, 2008
                                              18. Sonin AH: Magnetic resonance imaging of the extensor mechanism. Magn Reson Imaging Clin N Am. 2(3):401-11, 1994
                                              19. Yu JS et al: MR imaging of injuries of the extensor mechanism of the knee. Radiographics. 14(3):541-51, 1994
                                              Related Anatomy
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                                              Related Differential Diagnoses
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                                              References
                                              Tables

                                              Tables

                                              KEY FACTS

                                              • Terminology

                                                • Imaging

                                                  • Top Differential Diagnoses

                                                    • Pathology

                                                      • Clinical Issues

                                                        TERMINOLOGY

                                                        • Synonyms

                                                          • Quadriceps rupture, quadriceps tear, quad tear

                                                        • Definitions

                                                          • Partial or complete disruption of distal myotendinous units of quadriceps mechanism of thigh
                                                          • Quadriceps tendon: common distal tendon unit for rectus femoris, vastus medialis, vastus intermedius, and vastus lateralis muscles inserting on patella

                                                        IMAGING

                                                        • General Features

                                                          • Radiographic Findings

                                                            • CT Findings

                                                              • MR Findings

                                                                • Ultrasonographic Findings

                                                                  • Imaging Recommendations

                                                                    DIFFERENTIAL DIAGNOSIS

                                                                      PATHOLOGY

                                                                      • General Features

                                                                        • Staging, Grading, & Classification

                                                                          • Gross Pathologic & Surgical Features

                                                                            CLINICAL ISSUES

                                                                            • Presentation

                                                                              • Demographics

                                                                                • Natural History & Prognosis

                                                                                  • Treatment

                                                                                    DIAGNOSTIC CHECKLIST

                                                                                    • Consider

                                                                                      • Image Interpretation Pearls

                                                                                        • Reporting Tips

                                                                                          Selected References

                                                                                          1. Vajapey SP et al: Treatment of extensor tendon disruption after total knee arthroplasty: a systematic review. J Arthroplasty. 34(6):1279-86, 2019
                                                                                          2. Flores DV et al: Layered approach to the anterior knee: normal anatomy and disorders associated with anterior knee pain. Radiographics. 38(7):2069-101, 2018
                                                                                          3. Long JR et al: Postoperative imaging of the knee extensor mechanism. Semin Musculoskelet Radiol. 22(4):424-34, 2018
                                                                                          4. Zribi W et al: Spontaneous and simultaneous complete bilateral rupture of the quadriceps tendon in a patient receiving hemodialysis: a case report and literature review. World J Orthop. 9(9):180-4, 2018
                                                                                          5. McMahon CJ et al: The extensor mechanism: imaging and intervention. Semin Musculoskelet Radiol. 21(2):89-101, 2017
                                                                                          6. Severyns M et al: Arthroscopic suture repair of acute quadriceps tendon ruptures. Orthop Traumatol Surg Res. 103(3):377-80, 2017
                                                                                          7. Zuke WA et al: Quadriceps tendon rupture in an adolescent athlete. Case Rep Orthop. 2017:2718013, 2017
                                                                                          8. Yablon CM et al: Magnetic resonance imaging of the extensor mechanism. Magn Reson Imaging Clin N Am. 22(4):601-20, 2014
                                                                                          9. Lee D et al: Quadriceps and patellar tendon ruptures. J Knee Surg. 26(5):301-8, 2013
                                                                                          10. Hak DJ et al: Quadriceps tendon injuries. Orthopedics. 33(1):40-6, 2010
                                                                                          11. Basic-Jukic N et al: Spontaneous tendon ruptures in patients with end-stage renal disease. Kidney Blood Press Res. 32(1):32-6, 2009
                                                                                          12. Brooks P: Extensor mechanism ruptures. Orthopedics. 32(9), 2009
                                                                                          13. Yun HH et al: Calcific tendinitis of the rectus femoris. Orthopedics. 32(7):490, 2009
                                                                                          14. Bimmel R et al: Quadriceps tendon rupture and periosteal sleeve avulsion fracture of the proximal patella pole in an active adolescent. Orthopedics. 31(7):716, 2008
                                                                                          15. LaRocco BG et al: Ultrasound diagnosis of quadriceps tendon rupture. J Emerg Med. 35(3):293-5, 2008
                                                                                          16. McKinney B et al: Intra-articular knee injuries in patients with knee extensor mechanism ruptures. Knee Surg Sports Traumatol Arthrosc. 16(7):633-8, 2008
                                                                                          17. Pfirrmann CW et al: Quadriceps tendinosis and patellar tendinosis in professional beach volleyball players: sonographic findings in correlation with clinical symptoms. Eur Radiol. 18(8):1703-9, 2008
                                                                                          18. Sonin AH: Magnetic resonance imaging of the extensor mechanism. Magn Reson Imaging Clin N Am. 2(3):401-11, 1994
                                                                                          19. Yu JS et al: MR imaging of injuries of the extensor mechanism of the knee. Radiographics. 14(3):541-51, 1994