Patellar tendon rupture: Difference between revisions
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==Background== | ==Background== | ||
[[File:Knee diagram2.png|thumb|Anatomy of anterolateral aspect of right knee.]] | |||
*Occurs via forceful contraction of quadriceps muscle or falling on flexed knee | *Occurs via forceful contraction of quadriceps muscle or falling on flexed knee | ||
* | *Typically occur 2cm from insertion on patella | ||
==Clinical Features== | ==Clinical Features== | ||
*Sudden "pop" or tearing | |||
*Diffuse swelling | *Diffuse swelling | ||
*Defect may be palpable below the patella | |||
*Defect may be palpable | *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 DDX}} | ||
==Evaluation== | |||
[[File:Patellar_Tendon_Rupture.gif|thumbnail|Patellar tendon rupture<ref>http://www.thepocusatlas.com/musculoskeletal/</ref>]] | |||
*[[Ultrasound: Tendons|Ultrasound]] | |||
**Separation of the tendon can be visualized | |||
*X-ray | |||
**Patella alta (high-riding patella) | |||
{{Patellar vs Quadriceps tendon rupture}} | |||
==Management== | ==Management== | ||
*Ortho consult in the ED | *Ortho consult in the ED | ||
*Knee immobilizer, can be weight bearing | |||
*Operative repair advised within 7 days | |||
==Disposition== | |||
*Outpatient | |||
==See Also== | |||
*[[Quadriceps tendon rupture]] | |||
== | ==References== | ||
* | <references/> | ||
*Wheeless' Textbook of Orthopaedics | |||
[[Category: | [[Category:Orthopedics]] | ||
[[Category:Sports Medicine]] | |||
Latest revision as of 21:43, 21 May 2020
Background
- Occurs via forceful contraction of quadriceps muscle or falling on flexed knee
- Typically occur 2cm from insertion on patella
Clinical Features
- Sudden "pop" or tearing
- Diffuse swelling
- Defect may be palpable below 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
Patellar tendon rupture[1]
- Ultrasound
- Separation of the tendon can be visualized
- X-ray
- Patella alta (high-riding 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) |
Management
- Ortho consult in the ED
- Knee immobilizer, can be weight bearing
- Operative repair advised within 7 days
Disposition
- Outpatient
See Also
References
- Wheeless' Textbook of Orthopaedics