Muhammed Ali Topuz, İlker Kaçer
Journal of Emergency Medicine Case Reports - 2025;16(4):161-164
Spontaneous bilateral quadriceps tendon rupture (QTR) is a rare condition that can be severely debilitating. It is often associated with delayed diagnosis due to its nonspecific presentation and wide differential diagnosis. The following case report details a 64-year-old obese male with a medical history of diabetes mellitus who presented to the emergency department with acute bilateral thigh pain and an inability to ambulate following a non-traumatic incident. Physical examination revealed swelling, tenderness, palpable suprapatellar defects, and loss of active knee extension, with neurovascular status intact. Initial radiographic imaging and three-dimensional computed tomography (CT) scans did not reveal any fractures, and the patellae were in their typical anatomical locations. Point-of-care ultrasound (POCUS) suggested bilateral QTR, a finding that was subsequently confirmed by magnetic resonance imaging (MRI). The patient was referred for surgical intervention. Bilateral QTR primarily affects males over 40 years of age, often in the presence of comorbidities such as chronic renal failure, diabetes, obesity, or connec - tive tissue disorders. Although MRI is widely regarded as the gold standard for diagnosis, point-of-care ultrasound (POCUS) offers a rapid, cost-effective, and highly sensitive alternative in emergency settings. Early recognition of the condition is imperative to prevent functional disability. Clinicians are advised to maintain a high index of suspicion for QTR in patients presenting with acute extension deficits, even in the absence of trauma or radiographic abnormalities.
