Quadriceps Tendon Rupture in Chronic Kidney Disease: A Rare but Significant Complication
A 38-year-old man with end-stage renal disease presented with progressive difficulty in walking, leading to a diagnosis of quadriceps tendon rupture in both knees. This rare condition, often associated with chronic kidney disease and secondary hyperparathyroidism, underscores the complex interplay between systemic diseases and musculoskeletal health.
- The patient had been dealing with progressive walking difficulty for several years.
- Initial symptoms began with acute pain and swelling in both knees after a minor accident.
- Physical examination revealed a soft-tissue depression proximal to the patella and a palpable suprapatellar gap at the expected quadriceps tendon insertion site.
- The patient was unable to extend his knees and walked with flexed knees.
- Laboratory studies indicated secondary hyperparathyroidism.
- Radiographs showed inferior displacement of the patellae, leading to a diagnosis of quadriceps tendon rupture.
- Quadriceps tendon rupture may occur spontaneously or with minimal trauma in patients with chronic kidney disease and secondary hyperparathyroidism.
- The patient declined surgical repair and was lost to follow-up.
HCN Medical Memo
Because the kidneys are unable to effectively remove β2-m from the blood in renal disease patients, this leads to an accumulation of β2-m in the blood and tissues, including the muscles, which can ultimately lead to muscle ruptures.
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