title: Bilateral simultaneous rupture of the quadriceps tendon in a patient with psoriasis: a case report and review of the literature.
abstract: BACKGROUND
  Bilateral quadriceps tendon rupture is not common in the absence of systemic disease. Patients with chronic systemic diseases such as uremia and systemic lupus erythematosus and patients who are being treated with systemic steroids or local steroid injections are more prone to tendon rupture. The tendon can rupture spontaneously or as a result of trauma. We report an unusual case of simultaneous bilateral traumatic quadriceps tendon rupture in a patient with psoriasis who was being treated with topical steroid preparations.
  
  
  METHODS
  A 57-year-old Caucasian man with a known history of psoriasis, for which he was being treated with topical steroid preparations, presented to our hospital with clinical signs of bilateral quadriceps tendon rupture after he fell while walking down stairs. The diagnosis was confirmed by bilateral ultrasound scans of the thighs. The patient underwent surgery to repair both quadriceps tendons. Post-operatively, the patient was immobilized first in bilateral cylinder casts for six weeks, then in knee braces for the next four weeks. His knees were actively mobilized during physiotherapy.
  
  
  CONCLUSIONS
  Bilateral quadriceps tendon rupture is a rare occurrence in patients with psoriasis who are being treated with topical steroids.
authors.affiliation: Department of Trauma & Orthopaedics, Queen Elizabeth Hospital, Gateshead, NE9 6SX, UK. shanaka_s2004@yahoo.com.
authors.forename: Shanaka
authors.initials: S
authors.lastname: Senevirathna
authors.forename: Sarkell
authors.initials: S
authors.lastname: Radha
authors.forename: Aysha
authors.initials: A
authors.lastname: Rajeev