Knee Pain After Escaping A Dog - Page #1

Author: Skyler Gick, DO
Co Author #1: Skyler R. Gick
Co Author #2: Jacklyn D. Kiefer
Senior Editor: Krystian Bigosinski, MD
Editor: Michael Beasley, MD, FAMSSM

Patient Presentation:
51 yo M presented to sports medicine clinic for pain above right knee and decreased ability to extend his right leg x 3 weeks.
Three weeks prior, he was running away from a dog, missed a step when trying to jump into his truck and landed on an extended knee. When he landed, he felt a pop just above his knee joint with immediate swelling, pain, and inability to place weight on his right leg.
Patient went to the ED on the day of injury and there was concern for quadriceps tendon tear. He was placed in a medium knee immobilizer and advised to follow up with orthopedics.
He did not wear the knee immobilizer consistently and did not follow up with orthopedics prior to presenting to sports medicine clinic.
Patient works for a towing company and complained of having difficulty 'dollying' cars, as he was unable to carry the dolly and required a cane for ambulation.

History of hypertension, hyperlipidemia, and obesity.

Physical Exam:
BMI 39.9
Right knee exam:
Swelling proximal to patella. Normal alignment. Palpable 5 cm defect and tenderness at the distal quadriceps tendon proximal to the superior pole of the patella. Full passive ROM. Able to perform active straight leg raise against gravity, but has an approximate 15 degree extensor lag. Weakness with knee extension compared to contralateral side. Ligaments stable. Negative Lachman. Negative pivot shift.
LE DTRs 2+ bilaterally. Sensation intact. Dorsalis pedis pulse 2+.

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