Emergency Cases Northwest Group

076 A Kneat Diagnosis

Situation

An elderly man suffered a rectus femoris rupture.

Background

A 72 year old man felt sudden pain in his knee stepping aboard a bus. The knee swelled up immediately. He started using a cane but the leg still gave way every so often. The knee and thigh were a little swollen, mildly tender. The quadriceps tendon was difficult to feel. He could not extend his knee or straight leg raise at all. X-ray was normal.

Assessment

Clinically diagnosed as quadriceps tendon rupture, cricket pad splint applied, referred orthopaedics [they arranged o/p USS]. The USS revealed quadriceps tendon was intact but he had a severe “laceration of the distal rectus femoris [quadriceps] muscle near the myotendinous [muscle-tendon] junction”.

Recommendation

Know that in examination of the knee, assessing the extensor mechanism [via straight leg raise for example] is mandatory.

If this test is omitted an injury to any part of the extensor mechanism may be missed.

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Emergency Cases Northwest Group