Bilateral patellar tendon ruptures without predisposing systemic disease or steroid use: a case report and review of the literature
ABSTRACT Simultaneous bilateral patellar tendon rupture occurs rarely and is even rarer in patients without systemic disease or predisposing conditions. We present a case of bilateral, midsubstance patellar tendon ruptures along with a partial anterior cruciate ligament tear from a fall from a standing height in an otherwise healthy adult without any predisposing conditions. Most patients that sustain a tendon rupture have risk factors for tendonopathy including chronic renal disease, systemic lupus erythematosus, rheumatoid arthritis, or exposure to medications (such as corticosteroids or fluoroquinolones). Currently, there are approximately 50 reported cases of bilateral patellar tendon rupture in the scientific literature; however, only a small minority occurred in patients without any predisposing factors. Most of the reports of a bilateral tendon rupture without systemic disease occurred in the inferior pole of the tendon, with only a few of these occurring in the midsubstance. Because of the rarity of this event in a patient without systemic disease, this condition is often misdiagnosed. Emergency physicians should maintain a high degree of suspicion in those patients with concerning clinical and/or radiographic findings.
SourceAvailable from: Miroslav Ziva MilankovMedicinski pregled 01/2015; 68(1-2):22-28. DOI:10.2298/MPNS1502022K
Medicinski pregled 01/2015; 68(1-2):59-65. DOI:10.2298/MPNS1502059L
Research: RISK FACTORS OF THE FIRST STROKE[Show description] [Hide description]
DESCRIPTION: Introduction - This study was aimed at investigating the vascular risk factors associated with the first stroke. It highlighted unfavorable trends in stroke mortality in the region gravitating towards the general hospital in Doboj. Material and Methods - The study included all patients hospitalized with the diagnosis of first stroke and their main vascular risk factors were explored, both in terms of their importance in the occurrence of stroke, and in terms of gender and age lines. The research results were statistically processed, analyzed and commented on. Results - The most common risk factor for the first stroke included hypertension (70%), smoking (35%), heart diseases (28%), diabetes mellitus (28%), hyperlipoproteinemia (26%), atrial fibrillation (18.5%) and immoderate consumption of alcohol (17%). Conclusion - The presence of vascular risk factors in the majority of patients is important, and at least one of them was present in 80% of patients. Alcohol consumption, smoking and hyperlipoproteinemia were significantly more frequent in men, and atrial fibrillation was more frequent in women. Arterial hypertension, heart disease and diabetes mellitus were present in both sexes without significant difference. Key words: Risk Factors; Stroke; Epidemiology; Age Factors; Sex Factors; Cardiovascular Diseases