77: Quadriceps Tendinopathy and Tendinitis

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CHAPTER 77

Quadriceps Tendinopathy and Tendinitis

Farshad Adib, MD; Christine Curtis, MD; Peter Bienkowski, MD; Lyle J. Micheli, MD

Synonym

Quadriceps tendinosis

ICD-9 Codes

726.60  Enthesopathy of knee, unspecified

844.8   Sprains and strains of knee and leg, other specified sites

959.7   Injury, other and unspecified, knee, leg, ankle, and foot

ICD-10 Codes

M76.891  Enthesopathies of right lower limb, excluding foot

M76.892  Enthesopathies of left lower limb, excluding foot

M76.899  Enthesopathies of unspecified lower limb, excluding foot

S83.90 Sprain of unspecified site of unspecified knee

S83.91 Sprain of unspecified site of right knee

S83.92 Sprain of unspecified site of left knee

S89.90 Injury of unspecified lower leg

S89.91 Injury of right lower leg

S89.92 Injury of left lower leg

S99.911     Injury of right ankle

S99.912     Injury of left ankle

S99.919     Injury of unspecified ankle

S99.921     Injury of right foot

S99.922     Injury of left foot

S99.929  Injury of unspecified foot

Add seventh character to categories S83, S89, and S99 for episode of care

Definition

The quadriceps tendon is located at the insertion of the quadriceps muscle into the patella and functions as part of the knee extensor mechanism. Quadriceps tendinitis (or, as named in the more recent literature, tendinosis or tendinopathy) is an overuse syndrome characterized by repetitive overloading of the quadriceps tendon. The common mechanism of injury is microtrauma, in which the basal ability of the tissue to repair itself is outpaced by the repetition of insult [1]. Quadriceps tendinopathy often occurs in athletes participating in running and jumping sports as well as in persons who perform frequent kneeling, squatting, and stair climbing [2]. The superior strength, mechanical advantage, and better vascularity of the quadriceps tendon make quadriceps tendinopathy much less frequent than patellar tendinopathy [3].

Symptoms

Patients usually report an insidious onset of knee pain and may note painful clicking. Their chief complaint is usually “knee pain.” A burning sensation at the bone-tendon junction may be experienced [4

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