Musculoskeletal - Quad Tendon Rupture (Bilateral)
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40 year old M presented with bilateral knee pain and inability to extend knees after injuring knee while carrying heavy plywood boards. POCUS confirmed the diagnosis of bilateral quadriceps tendon rupture. On ultrasound you can see the retracted tendon independent of the patella as the knee is being actively ranged. Also visible is a surrounding traumatic hematoma. One should look for discontinuity in the tendon in longitudinal view to diagnose any sort of tendon rupture. Often, there is an adjacent fluid collection reflecting hematoma. Be careful not to interpret the anisotropy of the ultrasound as discontinuity. Anisotropy is that the US looks different in cross section vs longitudinal views, any variation in the direction of the tendons and the positioning of the probe can lead to a false positive. Dr. Nathan Frank, Dr. Benjamin Weissman, Dr. Walter Valesky - Kings County/SUNY Downstate Emergency Medicine