Simultaneous bilateral quadriceps tendon rupture in a patient with hyperparathyroidism undergoing long-term haemodialysis: a case report and literature review

J Int Med Res. 2013 Aug;41(4):1378-83. doi: 10.1177/0300060513490616. Epub 2013 Jun 26.

Abstract

Simultaneous bilateral quadriceps tendon rupture is a rare injury that represents < 5% of all quadriceps tendon ruptures. It is generally associated with chronic metabolic disorders and is seen in patients with uraemia undergoing maintenance haemodialysis. The present case was a 46-year-old man who presented with pain and the inability to extend his knees following a minor accident. A physical examination combined with X-radiography and magnetic resonance imaging investigations resulted in a diagnosis of bilateral quadriceps tendon rupture. He had a history of uraemia and had received regular haemodialysis for 7 years. He had high levels of serum parathyroid hormone and he was diagnosed with secondary hyperparathyroidism. Following surgical repair of both quadriceps tendons, in addition to management of the secondary hyperparathyroidism, the patient regained full active mobility of both knee joints and was able to participate in normal activities of daily living.

Keywords: Hyperparathyroidism; haemodialysis; quadriceps tendon; rupture.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Humans
  • Hyperparathyroidism, Secondary / blood
  • Hyperparathyroidism, Secondary / etiology
  • Hyperparathyroidism, Secondary / physiopathology
  • Kidney Failure, Chronic / blood
  • Kidney Failure, Chronic / complications
  • Kidney Failure, Chronic / physiopathology
  • Knee Joint / metabolism
  • Knee Joint / surgery*
  • Male
  • Middle Aged
  • Parathyroid Hormone / blood
  • Quadriceps Muscle / injuries
  • Quadriceps Muscle / metabolism
  • Quadriceps Muscle / surgery*
  • Renal Dialysis
  • Rupture / metabolism
  • Rupture / surgery*
  • Tendons / metabolism
  • Tendons / surgery*
  • Treatment Outcome
  • Uremia / blood
  • Uremia / physiopathology
  • Uremia / therapy

Substances

  • Parathyroid Hormone