Spontaneous bilateral quadriceps tendon rupture in a patient with renal failure

Description

A 45-year-old man with history of chronic renal failure had sudden onset of severe pain in both his knees following which he was unable to walk and had severe pain in both lower thighs and knee joints. On examination he was pale looking and asthenic. Local examination revealed swelling of bilateral knee joints with restricted extension of knee joints. On palpation small defect was noted in the suprapatellar region, indicating the discontinuity of quadriceps tendon. MRI of bilateral knee joints was done, revealing patella baja (low-lying patella), moderate-joint effusions and full-thickness defect in quadriceps tendons at site of patellar attachment (figures 1 and 2). The patient did not have any other tendon ruptures at the time of presentation to hospital. Due to poor renal function status, the patient was not fit for surgical repair and was immobilised with long leg cast in extension for 8 weeks followed...

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