A 21-year-old professional footballer presents to the Accident and Emergency unit with severe, stabbing pain just above his right knee joint. He states that the pain was of sudden onset and happened whilst he was sprinting during a match. On examination, he walks with a limp and is unable to extend the leg. There is a swelling over the supra-patellar region and is identified to have a low-lying patella. Knee jerk is absent.
(Please select 1 option)
0. Fracture of patella
0. Injury to the posterior cruciate ligament
0. Tear of adductor magnus muscle
0. Tear of biceps femoris tendon
0. Tear of quadriceps tendon
Answer:
Tear of quadriceps tendon
A quadriceps tear may occur in both young athletes and older patients. The usual mechanism of injury is from kicking, sprinting or whilst being engaged in a sports activity which exerts sudden strain to the quadriceps tendon. Patients with tear of the quadriceps tendon typically present with acute knee pain, swelling, and functional loss following a stumble or a fall. The common clinical presentations include painful gait, inability to extend the knee, inability to straight leg raise and supra patellar swelling. There may be a palpable defect in the suprapatellar area and a low-lying patella, but swelling initially may obscure this finding. Neurological examination of the thigh and knee may be normal except for decreased quadriceps motor function and an absent knee jerk.