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Quadriceps Contusion

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1. Quadriceps Contusion

Quadriceps Contusion Quadriceps Contusion Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Quadriceps Contusion Quadriceps Contusion (...) Aka: Quadriceps Contusion , Thigh Contusion From Related Chapters II. Mechanism Direct blow to thigh III. Signs: Limited knee flexion (Assess at 12 to 24 hour) Mild Injury flexion >90 degrees Moderate flexion 45-90 degrees Severe flexion <45 degrees IV. Management Phase 1: Wrap knee, extended to 130 degrees Phase 2: Range of Motion Phase 3: Return to Play Images: Related links to external sites (from Bing) These images are a random sampling from a Bing search on the term "Quadriceps Contusion

2018 FP Notebook

2. Morel-Lavallee Lesion Initially Diagnosed as Quadriceps Contusion: Ultrasound, MRI, and Importance of Early Intervention (PubMed)

Morel-Lavallee Lesion Initially Diagnosed as Quadriceps Contusion: Ultrasound, MRI, and Importance of Early Intervention Morel-Lavallee lesions (MLL) are rare, closed degloving injuries caused by trauma that delivers a shearing force to the soft tissue most commonly of the hip. If not treated in the acute and subacute setting these lesions are often complicated by re-accumulation of fluid, infection, or chronic pain. We present a unique case of a recurrent, massive medial knee/thigh MLL (...) in which proper treatment was delayed due to initial diagnosis of a quadriceps contusion. We describe the ultrasound and magnetic resonance imaging findings of this patient and based on a review of recent literature propose that the initial management should have included early drainage/debridement, which likely could have prevented recurrence and significantly shortened the clinical course.

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2015 Western Journal of Emergency Medicine

3. Quadriceps Contusion

Quadriceps Contusion Quadriceps Contusion Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Quadriceps Contusion Quadriceps Contusion (...) Aka: Quadriceps Contusion , Thigh Contusion From Related Chapters II. Mechanism Direct blow to thigh III. Signs: Limited knee flexion (Assess at 12 to 24 hour) Mild Injury flexion >90 degrees Moderate flexion 45-90 degrees Severe flexion <45 degrees IV. Management Phase 1: Wrap knee, extended to 130 degrees Phase 2: Range of Motion Phase 3: Return to Play Images: Related links to external sites (from Bing) These images are a random sampling from a Bing search on the term "Quadriceps Contusion

2015 FP Notebook

4. Contusions (Follow-up)

Author: Michael A Herbenick, MD; Chief Editor: Sherwin SW Ho, MD Share Email Print Feedback Close Sections Sections Contusions Follow-up Return to Play Contusions, in particular quadriceps contusions, [ ] should be observed closely after injury until the hemorrhage has stopped, which usually occurs 24-48 hours after the injury. It is important to consider compartment syndrome or muscle rupture if the pain or girth of the affected area has not stabilized by 48 hours postinjury. See the images below (...) . Athlete with a quadriceps strain. Place knee passively in 120º of flexion and immobilize with a double elastic wrap in a figure-8 fashion. This should occur within minutes of the injury. Used with permission courtesy of John Aronen, MD. Modified treatment of quadriceps contusion. Used with permission courtesy of John Aronen, MD. No objective data indicate when an athlete may safely return to competition. Each case must be evaluated on an individual basis, and the clinician' s best judgment must act

2014 eMedicine.com

5. Contusions (Diagnosis)

muscle contusions account for one third of all sports injuries. The quadriceps and gastrocnemius muscle groups are most often involved (see the images below). [ , , , ] A study that compared incidence, duration of absence and characteristics of indirect (strain) and direct (contusion) quadriceps and hamstring muscle injuries reported that these thigh injuries are more frequent than have been previously described. Direct injuries (contusion) are less frequent than indirect ones (strain), and players (...) can usually return to full activity in under half the average time for an indirect injury. [ ] Athlete with a quadriceps strain. Place knee passively in 120º of flexion and immobilize with a double elastic wrap in a figure-8 fashion. This should occur within minutes of the injury. Used with permission courtesy of John Aronen, MD. Modified treatment of quadriceps contusion. Used with permission courtesy of John Aronen, MD. Rotator cuff contusions of the shoulder have also been seen in professional

2014 eMedicine.com

6. Contusions (Treatment)

, Menetrey J, Somogyl G, et al. Development of approaches to improve the healing following muscle contusion. Cell Transplant . 1998 Nov-Dec. 7(6):585-98. . Nozaki M, Li Y, Zhu J, et al. Improved muscle healing after contusion injury by the inhibitory effect of suramin on myostatin, a negative regulator of muscle growth. Am J Sports Med . 2008 Dec. 36(12):2354-62. . Jackson DW, Feagin JA. Quadriceps contusions in young athletes. Relation of severity of injury to treatment and prognosis. J Bone Joint Surg (...) Am . 1973 Jan. 55(1):95-105. . . Rothwell AG. Quadriceps hematoma. A prospective clinical study. Clin Orthop Relat Res . 1982 Nov-Dec. 171:97-103. . Ryan JB, Wheeler JH, Hopkinson WJ, Arciero RA, Kolakowski KR. Quadriceps contusions. West Point update. Am J Sports Med . 1991 May-Jun. 19(3):299-304. . Kary JM. Diagnosis and management of quadriceps strains and contusions. Curr Rev Musculoskelet Med . 2010 Jul 30. 3(1-4):26-31. . . Ueblacker P, Mueller-Wohlfahrt HW, Ekstrand J. Epidemiological

2014 eMedicine.com

7. Contusions (Overview)

muscle contusions account for one third of all sports injuries. The quadriceps and gastrocnemius muscle groups are most often involved (see the images below). [ , , , ] A study that compared incidence, duration of absence and characteristics of indirect (strain) and direct (contusion) quadriceps and hamstring muscle injuries reported that these thigh injuries are more frequent than have been previously described. Direct injuries (contusion) are less frequent than indirect ones (strain), and players (...) can usually return to full activity in under half the average time for an indirect injury. [ ] Athlete with a quadriceps strain. Place knee passively in 120º of flexion and immobilize with a double elastic wrap in a figure-8 fashion. This should occur within minutes of the injury. Used with permission courtesy of John Aronen, MD. Modified treatment of quadriceps contusion. Used with permission courtesy of John Aronen, MD. Rotator cuff contusions of the shoulder have also been seen in professional

2014 eMedicine.com

8. Delayed presentation of compartment syndrome of the thigh secondary to quadriceps trauma and vascular injury in a soccer athlete (PubMed)

in a good functional outcome at 2-years follow-up.A high index of suspicion for compartment syndrome is needed in all severe quadriceps contusion. Vascular injury can cause thigh compartment syndrome in sports trauma. MRI findings of deep thigh muscle swelling and "blow-out" tear of the vastus lateralis are strongly suggestive of severe quadriceps injury, and may be a harbinger of delayed thigh compartment syndrome.Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved. (...) Delayed presentation of compartment syndrome of the thigh secondary to quadriceps trauma and vascular injury in a soccer athlete Compartment syndrome isolated to the anterior thigh is a rare complication of soccer injury. Previous reports in the English literature on sports trauma-related compartment syndrome of the thigh are vague in their description of the response of thigh musculature to blunt trauma, magnetic resonance imaging (MRI) findings of high-risk features of compartment syndrome

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2015 International journal of surgery case reports

9. Quadriceps Injury (Treatment)

are candidates for excision of the partial tear if they do not improve with a rehabilitation program and the diagnosis is confirmed by MRI. Consultations An orthopedic surgeon should be consulted for compartment syndrome or quadriceps rupture (complete or partial) at the insertion on the patella. Other Treatment For a quadriceps contusion, immediately putting the knee in 120° of flexion (first 10 min) tamponades the hemorrhage and limits muscle spasm. This provides a more rapid return to normal range (...) with permission courtesy of John Aronen, MD. Simple contusion care Immobilize knee in 120° of flexion with elastic bandage or adjustable knee brace for 24 hours. This should be completed by wrapping the knee in a figure-8 fashion with 2- X 6-inch ACE wraps that have been sewn together end-to-end. Crutches are needed. Apply ice for 20 minutes every 2-3 hours. Discontinue 120° of flexion at 24 hours and begin electrical stimulation and/or passive stretching, followed by icing. Begin active pain-free quadriceps

2014 eMedicine.com

10. Quadriceps Injury (Overview)

Author: Thomas M DeBerardino, MD; Chief Editor: Craig C Young, MD Share Email Print Feedback Close Sections Sections Quadriceps Injury Overview Background Several types of quadriceps injuries can occur, the most common being the quadriceps contusion, which is painful and disabling. The usual cause of the quadriceps contusion is a direct blow to the anterior thigh from an object or another person (eg, helmet, knee). Very rarely, this injury can be severe enough to progress to an acute compartment (...) quadriceps injuries range from simple strains to more complex and disabling muscle ruptures. See the image below. Modified treatment of quadriceps contusion. Used with permission courtesy of John Aronen, MD. Other types of quadriceps injuries include strains of the quadriceps tendon, complete and partial tears of the quadriceps tendon, and fascial rupture of the quadriceps muscle. Specific areas of the quadriceps are affected for each of these diagnoses. The classic quadriceps strain occurs

2014 eMedicine.com

11. Quadriceps Injury (Follow-up)

in 2-5 days. A protective pad larger than the area of contusion should be worn for the remainder of the season. Next: Complications Myositis ossificans may occur at 3 or more months postinjury. Previous Next: Prevention Remove player from activity at the time of initial injury because the risk of a more severe injury is increased when the player is already in a weakened state. Protective padding should be worn in sports with high risk for quadriceps injury and by players who have already sustained (...) such an injury. Previous Next: Prognosis If treated properly, a full recovery is expected, although recovery times vary from days to months. Previous Next: Education For patient education resources, see the , as well as . Previous References Ryan JB, Wheeler JH, Hopkinson WJ, Arciero RA, Kolakowski KR. Quadriceps contusions. West Point update. Am J Sports Med . 1991 May-Jun. 19(3):299-304. . Eckard TG, Kerr ZY, Padua DA, Djoko A, Dompier TP. Epidemiology of Quadriceps Strains in National Collegiate Athletic

2014 eMedicine.com

12. Quadriceps Injury (Diagnosis)

, 2017 Author: Thomas M DeBerardino, MD; Chief Editor: Craig C Young, MD Share Email Print Feedback Close Sections Sections Quadriceps Injury Overview Background Several types of quadriceps injuries can occur, the most common being the quadriceps contusion, which is painful and disabling. The usual cause of the quadriceps contusion is a direct blow to the anterior thigh from an object or another person (eg, helmet, knee). Very rarely, this injury can be severe enough to progress to an acute (...) quadriceps injuries range from simple strains to more complex and disabling muscle ruptures. See the image below. Modified treatment of quadriceps contusion. Used with permission courtesy of John Aronen, MD. Other types of quadriceps injuries include strains of the quadriceps tendon, complete and partial tears of the quadriceps tendon, and fascial rupture of the quadriceps muscle. Specific areas of the quadriceps are affected for each of these diagnoses. The classic quadriceps strain occurs

2014 eMedicine.com

13. Diagnosis and management of quadriceps strains and contusions (PubMed)

Diagnosis and management of quadriceps strains and contusions Injuries to the quadriceps muscle group occur frequently in sports and athletic activities. Muscle strains and contusions constitute the majority of these injuries. The clinical presentation and assessment of quadriceps strains and contusions are reviewed along with discussion of appropriate imaging used in diagnosis. Treatment protocols for acute injuries are reviewed including rehabilitation techniques frequently utilized during (...) recovery. Special consideration is given to discussing the criteria for return to sports for athletes after injury. Myositis ossificans is a potentially disabling complication from quadriceps contusions and risk factors, prevention, and treatment are reviewed.

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2010 Current reviews in musculoskeletal medicine

14. Epidemiological and clinical outcome comparison of indirect ('strain') versus direct ('contusion') anterior and posterior thigh muscle injuries in male elite football players: UEFA Elite League study of 2287 thigh injuries (2001-2013). (PubMed)

Epidemiological and clinical outcome comparison of indirect ('strain') versus direct ('contusion') anterior and posterior thigh muscle injuries in male elite football players: UEFA Elite League study of 2287 thigh injuries (2001-2013). Data regarding direct athletic muscle injuries (caused by a direct blunt or sharp external force) compared to indirect ones (without the influence of a direct external trauma) are missing in the current literature--this distinction has clinical implications.To (...) compare incidence, duration of absence and characteristics of indirect and direct anterior (quadriceps) and posterior thigh (hamstring) muscle injuries.30 football teams and 1981 players were followed prospectively from 2001 until 2013. The team medical staff recorded individual player exposure and time-loss injuries. Muscle injuries were defined as indirect or direct according to their injury mechanism.In total, 2287 thigh muscle injuries were found, representing 25% of all injuries. Two thousand

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2015 British Journal of Sports Medicine

15. Sonography of the quadriceps muscle: Examination technique, normal anatomy, and traumatic lesions (PubMed)

Sonography of the quadriceps muscle: Examination technique, normal anatomy, and traumatic lesions Lesions of the quadriceps muscle (QM) are frequently seen by sonographers, and in most cases they are the result of sports-related trauma. An accurate assessment of the severity of the lesion is essential, particularly when the patient is a professional athlete. In most cases, careful history-taking and a thorough physical examination are sufficient for making the diagnosis and indicating the most (...) suitable imaging studies for each case. Clinical assessment alone, however, may not be sufficient for distinguishing contusions from small, partial tears or for estimating the size of a tear. Therefore, at least in patients who are professional athletes, imaging studies are necessary to plan appropriate therapy that will allow prompt functional recovery. Muscles cannot be visualized with conventional radiography, but it is used routinely in prepubertal patients because it can detect apophyseal

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2010 Journal of ultrasound

16. Overview of musculoskeletal pain

-extremity paraesthesia brought on by ambulation and relieved by sitting. Sport-related injuries may be generally categorised as acute or chronic; the range of medical conditions potentially resulting from sport- or exercise-related injuries is wide. More than 90% of all sport-related injuries are either contusions or strains. Jarvinen MJ, Lehto MU. The effects of early mobilisation and immobilisation on the healing process following muscle injuries. Sports Med. 1993;15:78-89. http://www.ncbi.nlm.nih.gov (...) characterised by a combination of pain, swelling, and impaired performance. Common sites include the rotator cuff (supraspinatus tendon), wrist extensors (lateral epicondyle) and pronators (medial epicondyle), patellar and quadriceps tendons, and Achilles' tendon. Tenosynovitis of the hand and wrist is a group of entities with a common pathology involving the extrinsic tendons of the hand and wrist and their corresponding retinacular sheaths. It usually starts as tendon irritation manifesting as pain

2018 BMJ Best Practice

17. Exercise-Based Knee and Anterior Cruciate Ligament Injury Prevention

4 seconds, focusing on “finding” your muscles. Stretching is only recommended in cases of limited range of motion Standing calf stretch Standing quadriceps stretch Half-kneeling hamstring stretch Half-kneeling hip flexor stretch Butterfly adductor stretch Modified figure-of-four stretch PEP None 50 yd each, 30 × 2 repetitions each Calf stretch Quadriceps stretch Figure-of-four hamstring stretch Inner thigh stretch Hip flexor stretch Sportsmetrics None 3 sets of 30 seconds each, or 2 laps (...) Gastrocnemius Soleus Quadriceps Hamstrings Hip flexors Iliotibial band/lower back Posterior deltoids Latissimus dorsi Pectorals/biceps Running HarmoKnee None As part of warm-up, 10 minutes total, separate times for each Jogging (4–6 minutes) Backward jogging on toes (1 minute) High-knee skipping (30 seconds) Defensive pressure technique: sliding slowly, zigzag backward (30 seconds) Alternating forward zigzag running and pressure technique: zigzag backward (2 minutes) KLIP None 4 phases, each lasting 2 wk

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2018 The Orthopaedic Section of the American Physical Therapy Association (APTA), Inc.

19. Acute Trauma to the Knee

for diagnosing certain knee injuries, however. Neubauer et al [17] reported that the correct diagnosis of bilateral quadriceps tendon rupture was established in only 61% (17/28) of cases by history and clinical examination alone. Weber et al [5] reported that fractures missed on clinical examination included fractures of the patella, tibial spine, and fibular head. Magnetic Resonance Imaging In addition to clinically significant fractures, other injuries must be considered in patients with acute knee pain (...) is higher than initially suspected. In randomized studies of patients with knee injuries [22,23], MRI findings have been shown to shorten the time to completion of diagnostic workup, reduce the number of additional diagnostic procedures, improve quality of life in the first 6 weeks, and potentially reduce costs associated with lost productivity. Koster et al [24] showed that the presence of a bone contusion on MRI after acute trauma is highly predictive of the development of focal osteoarthritis 1 year

2014 American College of Radiology

20. Should I Have Meniscus Surgery?

are as follows: “No evidence of fracture or dislocation. No suspicious focal bony lesion. No obvious soft tissue abnormality. Trace joint effusion. Quadriceps tendon and patellar tendon are intact. Anterior cruciate ligament and posterior cruciate ligament are intact. Medial collateral ligament and lateral collateral ligament are intact. Mild anterior extrusion of the anterior horn of the medial meniscus. Complex tear involving the posterior horn of the medial meniscus which extends into the body (...) meniscus on my left knee. I’ve been to an orthopedic surgeon who said that based on the time (6-7 weeks) since the injury happened he’s happy with my progress and doesn’t want to operate on my knee, but since then it’s been about 3-4 weeks and I really cant honestly say i’ve improved , if anything my knee feels worse and more painful, but i’ve noticed i have more flexibility when pulling my ankle back as if to stretch my quadriceps? So i guess what i’m asking is do you have any idea how long i’d

2016 Howard J. Luks, MD blog

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