Letter to the Editor: “MR imaging of the quadriceps femoris tendon: distal tear characterization and clinical significance of rupture types”
by Karen Cifuentes, Rafael Gómez, Sergio Valencia (sevava92@gmail.com)
MR imaging of the quadriceps femoris tendon: distal tear characterization and clinical significance of rupture typesDear Editor-in-Chief,
We read with interest the article entitled “MR imaging of the quadriceps femoris tendon: distal tear characterization and clinical significance of rupture types” [1]. It is an interesting and educational paper. Nevertheless, we have a few questions for the authors.
This investigation was focus on MRI findings, but on acute settings and ambulatory settings, the first image that we should interpret is plain radiography of the knee, in this paper authors evaluated the bony avulsion to predict a tendon rupture and it was found in 46% of the patients, there is the half of patient that presents without bony avulsion. There are other radiography findings that can help in the suspect of quadriceps tendon rupture as joint effusion, loss of normal fascial planes and linear calcification on suprapatellar soft tissues [2, 3]. It is important to evaluate the role of these findings without bone avulsion to determine if there are enough to suspect a quadriceps tendon tear.
Another doubt that we have is the time between MR and symptoms presentation. We believe there can be indirect signs that can be evaluated, many partial tears can health over time, and as seeing in other investigation according to the time of symptoms presentation and the MRI there can be changes on interpretation correlation between observers as see in other knee injuries an [4].