Distal Quadriceps Tendinosis

Home
About Us
- - About Us
  - About AMSSM
  - FAMSSM Designation
  - Awards
  - Founders
  - Past Presidents
  - Board of Directors
  - Committees
  - Contact Us
  - Bylaws/Policy & Committee Handbooks
- - FAMSSM Applications
  - Application submission is now closed for the 2026 Class of AMSSM Fellows. New Fellows will be announced to the AMSSM membership after the first of the year and honored at the 2026 Annual Meeting.
    
    Applications for the FAMSSM Designation will be available on an annual basis. Please contact Ellen Glasgow with any questions regarding the FAMSSM application.
- - We Understand You

Communications
- - Communications
  - Collaborate.AMSSM.org
  - New Branding Campaign
  - AMSSM Member Marketing Toolkit
  - Journal Access
  - Publications/Position Statements
  - Press Releases
  - Brochures
  - Weekly Digests
- - Online AMSSM Community for Members
  - AMSSM Collaborate online community provides a forum for year-long connection, giving members the chance to have conversations, share resources and make connections with your peers.
- - AMSSM Informational Brochures
  - Find informational brochures about sports medicine physicians geared toward coaches, parents and other healthcare professionals.
Education
- - AMSSM Sports Medcasts
  - Find all current and past AMSSM Sports Medcast episodes in one convenient location.
- - AMSSM Fellow Online Lecture Series
  - The AMSSM National Fellow Online Lecture Series features talks from national experts on fundamental sports medicine topics pertinent to fellowship training and sports medicine board certification. Go to the collaborate.amssm.org site and view the available lectures in the Upcoming Events area.
Research
Advocacy
- - Legislative and Policy Issues
  - AMSSM is the go-to organization for legislative and policy issues related to sports medicine and athlete health and safety.
- - Legislation by State
  - AMSSM offers a variety of advocacy resources, including a map that tracks legislation important to sports medicine physicians.
Sports US
- - Sports Ultrasound Online Didactics
  - These 35 educational modules cover all of the didactic instructional session topics recommended for sports medicine fellows by the AMSSM.
- - Sports Ultrasound Committee
  - Find all the resources, materials and guidelines from the AMSSM Sports Ultrasound Committee
Patients
- - Need a Sports Medicine Physician?
  - FindADoc
- - SportsMedToday.com
  - Your comprehensive sports medicine resource for athletes, coaches and parents.
Additional Information
- - Additional Information
  - Sports Med Today
  - Journals
  - Weekly Digests
  - Store
  - Careers
  - Industry
Foundation

Distal Quadriceps Tendinosis

Authors, Editors, Case Information Author: Bryson Merrill, MD Affiliation: Womack Army Medical Center, Fort Bragg, NC Co Author(s): Alex Houser, DO, CAQSM, FAAFP Senior Editor: Nicholas Moore, MD Clinical Vignette: A 30-year-old female presented with a 3-month history of insidious onset of right superior knee pain. Pain was worse with jumping, running, and going up and down stairs. She endorsed the occasional sensation of her quadriceps "giving out", particularly when going downstairs. Type of Probe Used: 15-4 MHz Linear Transducer Unlabeled long axis view of the distal quadriceps tendon Unlabeled long axis view of the distal quadriceps tendon. Unlabeled short axis view of the distal quadriceps tendon Unlabeled short axis view of the distal quadriceps tendon. Unlabeled long axis view comparing bilateral distal quadriceps tendons Unlabeled long axis view comparing bilateral distal quadriceps tendons. Image A is the asymptomatic side measuring approximately 0.75 cm thick, while Image B is the symptomatic side measuirng approximately 1.25 cm thick. Labeled long axis view of the distal quadriceps tendon Labeled long axis view of the distal quadriceps tendon (Q). Note the area of tendinosis (arrowheads) with irregular echotexture, thickening, and disorganization of the linear tendon fibers. patella (P); femur (F); quadriceps fat pad (QF); prefemoral fat pad (PF); suprapatellar joint recess (arrow). Labeled short axis view of the distal quadriceps tendon Labeled short axis view of the distal quadriceps tendon with evidence of irregular echotexture and thickening consistent with tendinosis (arrowheads). Interpretation Image Interpretation: The distal quadriceps tendon exhibits fusiform thickening of approximately 1.25 cm proximal to the superior patellar pole compared to approximately 0.75 cm on the asymptomatic side. There is a heterogeneous hypoechoic signal with loss of compact fibrillar structure within the area of maximal tenderness consistent with quadriceps tendinosis. Teaching Pearl: Quadriceps tendinosis is less common than patellar tendinopathy but should be considered in athletes with insidious anterior knee pain worsened by squatting, resisted knee extension, jumping, or heavy lifting. Ultrasound findings include fusiform tendon thickening, hypoechogenicity, loss of the normal fibrillar pattern, and possible Doppler signal at the symptomatic portion of the distal quadriceps tendon. Treatment is typically load modification with progressive strengthening, often using eccentric or heavy-slow resistance principles. Ultrasound can help confirm the pain generator and identify partial tearing, but management should still be guided by symptoms and load tolerance. References: 1. McMahon CJ, Ramappa A, Lee K. The extensor mechanism: imaging and intervention. Semin Musculoskelet Radiol. 2017;21(2):89-101. doi:10.1055/s-0037-1599207 2. Cook JL, Rio E, Purdam CR, Docking SI. Revisiting the continuum model of tendon pathology: what is its merit in clinical practice and research? Br J Sports Med. 2016;50(19):1187-1191. doi:10.1136/bjsports-2015-095422 3. Catapano M, Babu AN, Tenforde AS, Borg-Stein J, McInnis KC. Knee Extensor Mechanism Tendinopathy: Evaluation, Treatment, and Prevention. Curr Sports Med Rep. 2022;21(6):205-212.
NOTE: For more information, please contact the AMSSM, 4000 W. 114th Street, Suite 100, Leawood, KS 66211 (913) 327-1415.

Back		Top

UPCOMING EVENTS

_________________________________

12/11-12/13/2025
2025 Advanced Team Physician Course

_________________________________

1/09-1/11/2026
2026 AMSSM/South Bend Sports US

FIND A SPORTS DOC

Please enter a search term relevant to the search type. For US States - use only letter abbreviations.

Choose Search Type

© The American Medical Society for Sports Medicine
4000 W. 114th Street, Suite 100
Leawood, KS 66211
Phone: 913.327.1415

Website created by the computer geek

Authors, Editors, Case Information

Unlabeled long axis view of the distal quadriceps tendon

Unlabeled short axis view of the distal quadriceps tendon

Unlabeled long axis view comparing bilateral distal quadriceps tendons

Labeled long axis view of the distal quadriceps tendon

Labeled short axis view of the distal quadriceps tendon

Interpretation

UPCOMING EVENTS

FIND A SPORTS DOC