QUADRICEPS INJURY

TYPES

• Hematoma– Violaceous discoloration of the anterior thigh- this is the most common type of injury caused by a blunt force applied accidentally of intentionally 
• Compartment Syndrome– Presence of continuous bleeding within the anterior compartment of the thigh that causes impingement of the surrounding structures
• Atrophy of overuse– this is especially seen in patients who are always standing up of their feet and also those who play professional sports
• Strained quadriceps tendon– classified as follows:

Grade 1- limited to the muscle fibers, the outcome is usually an overstretched muscle

Grade 2- There is a portion of the muscle and the tendon that is torn with a notable damage

Grade 3- Complete tear of the muscle

• Inflammation of the tendon above the knee cap also labeled as quadriceps tendinitis

SYMPTOMS

• Pain and swelling of the anterior thigh
• Limitation of motion of the affected extremity
• Inability to extend the knee on the affected side
• Some cases can result in extreme pain with loss of sensory abilities on the affected limb which is termed as Compartment’s Syndrome
• Inability to stand on the affected leg

DIAGNOSIS

• Plain radiograph– this is requested to rule out the presence of bony deformities which may mimic quadriceps injury
• Ultrasonography– This diagnostic modality is used to determine if there is a complete or incomplete tear of the quadriceps tendon
• Tests used to determine the presence of rhabdomyolysis– this is apparent from the color of freshly excreted urine
• Creatinine phosphokinase (CPKMM)– this particular subset of creatine phosphokinase is a realistic marker of muscle wasting found in quadriceps injury
• Insertion of a probe on the anterior thigh to measure the pressure to rule out rapidly developing hematoma that results in compartment syndrome

TREATMENT

For quadriceps injury resulting from pulling and overstretching, the following can be employed as a mode of treatment:

• Use of analgesics such as ibuprofen, naproxen and diclofenac to mention a few
• Cold compression of the affected area to minimize the swelling and inflammation
• Immobility and rest of the affected muscle
• Use of assistive devices such as cane, crutches and in severe injuries, use of rollator and crutches to decrease the weight borne by the affected side
• Elevating the affected extremity using two large pillows- Hastens the blood flow to the area of injury
• Once the swelling has reduced, to return to its normal function, physical rehabilitation may be beneficial, especially for those individuals who play professionally.