Reason: left knee quad tendon rupture - need to evaluate to mid-femur in addition to knee. History: above There is a full-thickness incomplete tear of the quadriceps tendon. The tendon of the vastus intermedius appears intact and can be followed to its insertion on the patella. There is a full-thickness tear of the middle layer of the quadriceps tendon composed of the fibers of the vastus medialis as well as the vastus lateralis, with approximately 2 to 3 cm of proximal retraction. There also appears to be a full-thickness tear of the rectus femoris at its patellar insertion, with minimal retraction. The more posterior "oblique" tendons of the vastus medialis and vastus lateralis can be followed to the medial and lateral retinacular structures, respectively.There is mild edema within the quadriceps musculature, indicating strain injury. Lobular fluid signal intensity is noted anterior to the vastus intermedius muscle extending cranially approximately 10 cm, likely a thin hematoma. There is mild undulating contour of the patellar tendon, which otherwise appears intact. The remainder of the musculature of the distal thigh and proximal leg appears normal.Please note, this study was not protocoled for detailed evaluation of the knee. However, there appears to be mucoid degeneration of the anterior horn of the lateral meniscus with signal abnormality in the underlying tibial plateau. There is additional edema in the subcutaneous fat, particularly anteriorly and laterally. A knee joint effusion is present.Large field-of-view images provided limited evaluation of the right knee, which demonstrates edema-like signal in the vastus medialis obliquus as well as the vastus lateralis, suggesting strain injuries.
Left quadriceps tendon rupture as described above, involving the rectus femoris, vastus medialis, vastus lateralis, with sparing of the vastus intermedius.