Ultrasound Diagnosis of the Bilateral Quadriceps Tendon Ruptures in Patients with end-stage Renal Diseases Receiving Long - Term Dialysis

Abstract

Purpose: to assess the incidence of quadriceps tendon ruptures in patients with end-stage kidney disease treated with dialysis, to establish ultrasound characteristics in the setting of this complication and to analyze correlation between established deviations and calcium phosphate metabolism disorder. Materials and methods. We performed clinical, laboratory and ultrasound examination of 175 patients aged 17 to 73 years with end-stage kidney disease on dialysis. Duration of dialysis averaged 60 months (0.5 to 230 months). Results. During the observation period there were three cases of quadriceps tendon ruptures. Average age of patients with ruptures was 40 years; average duration of dialysis was 76.7 months. We analyzed correlation between this observed complication and calcium phosphate metabolism disorder. We also established ultrasound characteristics of quadriceps tendon ruptures of different duration. The most common site of tendon rupture was close to its insertion to the patella, which in some cases was accompanied by the superior pole avulsion. Another found characteristic was quadriceps calcification. Conclusion. Ultrasound is an inexpensive and informative tool for diagnosis of spontaneous quadriceps tendon ruptures. Our data confirms leading role of the high level of the parathyroid hormone and hyperphosphatemia in development of the spontaneous tendon ruptures in dialysis patients.