Author: Matthew Negaard, MD
Co Author #1: Timothy W. Thomsen
University of Iowa Department of Emergency Medicine, Department of Orthopedics and Rehabilitation
Senior Editor: Michelle Szczepanik, MD
Editor: Mandeep Ghuman, MD, FAMSSM
Patient Presentation:
A 48-year-old male presented to the Emergency Department for bilateral anterior knee pain after playing pick-up basketball.
History:
A 48-year-old male with no significant past medical history and not on any medications presented to the Emergency Eepartment for bilateral anterior knee pain. While playing pickup basketball, he jumped for a rebound, landed on both feet, and felt a pop on the anterior aspect of his both knees. He was unable to ambulate or fully extend his knees despite being able to fire his quadriceps muscles. He reported he was recently training for a sprint triathlon and bicycling more than usual but denied any previous knee issues.
Physical Exam:
Bilateral Lower Extremities: No joint effusions were noted. Visibly and palpable high-riding patellae. No medial or lateral joint line tenderness. There was a palpable defect proximal to the tibial tubercle. Able to fire quadriceps muscles, but extensor mechanism was deficient. The patient had sensation intact to light touch in the superficial peroneal, deep peroneal, tibial, saphenous, and sural nerve distributions bilaterally. 2+ dorsalis pedis artery pulse and 2+ posterior tibial artery pulse.
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