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Case Reports
. 2019 Mar;98(10):e14809.
doi: 10.1097/MD.0000000000014809.

Simultaneous spontaneous bilateral quadriceps tendon rupture with secondary hyperparathyroidism in a patient receiving hemodialysis: A case report

Weiqian Wu  1 , Chongyang Wang  2 , Jianwei Ruan  1 , Haibao Wang  1 , Yang Huang  1 , Wenbiao Zheng  1 , Fanghu Chen  1
Affiliations
Case Reports

Simultaneous spontaneous bilateral quadriceps tendon rupture with secondary hyperparathyroidism in a patient receiving hemodialysis: A case report

Weiqian Wu et al. Medicine (Baltimore). 2019 Mar.

Abstract

Rationale: Simultaneous spontaneous bilateral quadriceps tendon rupture is a rare orthopedic injury; its initial diagnosis is misdiagnosed in up to 50% of patients with secondary hyperparathyroidism. Early diagnosis and surgical repair are important to achieve an excellent functional outcome.

Patient concerns: We report a case of simultaneous spontaneous bilateral quadriceps tendon rupture associated with secondary hyperparathyroidism.

Diagnosis: Magnetic resonance imaging showed that the quadriceps tendon was completely ruptured at the osteotendinous junction. We then found bilateral quadriceps tendon rupture during the operation.

Interventions: The patient underwent successful tendon repair surgery.

Outcomes: The 31-year-old female patient regained full active movement of both knee joints and was able to participate in her activities of daily living.

Lessons: Simultaneous spontaneous bilateral quadriceps tendon rupture in a patient with secondary hyperparathyroidism (undergoing hemodialysis) is a rare orthopedic injury that can be easily overlooked at the initial presentation. Early diagnosis and surgical repair is important to achieve an excellent functional outcome. For patients with secondary hyperparathyroidism receiving hemodialysis, strict systematic treatment of hyperparathyroidism is needed to prevent rupture or re-rupture of the quadriceps tendon.

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Conflict of interest statement

The authors declare that there is no conflict of interest.

Figures

Figure 1
Figure 1
(A) Photograph of both knees revealing the bilateral soft tissue gap in the suprapatellar region. (B) Bilateral lateral radiography of her knees revealed inferior displacement of both patellas with irregular calcified deposits in the suprapatellar region (quadriceps tendon).
Figure 2
Figure 2
(A) Preoperative T2-weight sagittal MRIs of both knees clearly show the rupture at the osteotendinous junction as indicated by the arrows. (B) Intraoperatively, bilateral complete rupture between quadriceps tendon and patella was identified. (C) Postoperative sagittal T2-weighted MRIs of the knees revealed the normal continuity of the repaired quadriceps tendon with the superior pole of patella. MRIs = magnetic resonance images.
Figure 3
Figure 3
The patient regained full active movement of both knee joints and was able to participate in her activities of daily living.
See this image and copyright information in PMC

References

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