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Partial rupture of the quadriceps muscle in a child
Gokhan Aydemir1, Selami Cakmak, Secil Aydinoz
1Department of Pediatrics, Aksaz Military Hospital 48150, Marmaris, Mugla, Turkey. draydemir73@yahoo.com
Insights
This case study reports the youngest patient, a 4-year-old, with a quadriceps femoris muscle rupture. Multiple thigh injections may increase the risk of muscle tears in children.
Area of Science:
- Pediatric Orthopedics
- Musculoskeletal Injuries
- Medical Case Reports
Background:
- Quadriceps femoris muscle ruptures are typically observed in middle-aged individuals.
- This report details an exceptionally rare case of quadriceps femoris muscle rupture in a 4-year-old child.
- It represents the youngest documented instance of this injury.
Observation:
- A 4-year-old girl presented with left knee pain and restricted movement after jumping.
- Physical examination revealed swelling on the anterolateral thigh.
- A history of multiple intramuscular Clindamycin injections in the same thigh for a respiratory infection was noted.
Findings:
- Magnetic Resonance Imaging (MRI) confirmed a partial tear of the vastus lateralis muscle.
- The tear's location correlated with the sites of previous intramuscular injections.
- Conservative treatment, including a three-week leg cast, resulted in positive clinical outcomes.
Implications:
- Repeated intramuscular injections in the same muscle site may predispose pediatric patients to muscle damage and tears.
- Healthcare providers should exercise caution, rotating injection sites between limbs to mitigate risks.
- This case highlights the importance of considering iatrogenic causes for musculoskeletal injuries in children.
Background:
The quadriceps femoris muscle ruptures usually occur in the middle-aged population. We present a 4-year-old patient with partial rupture of the quadriceps femoris muscle. To our knowledge, this is the youngest patient reported with a quadriceps femoris muscle rupture.
Case Presentation:
A 4-year-old girl admitted to our clinic with left knee pain and limitation in knee movements. Her father reported that she felt pain while jumping on sofa. There was no direct trauma to thigh or knee. We located a palpable soft tissue swelling at distal anterolateral side of thigh. The history revealed that 10 days ago the patient was treated for upper tract respiratory infection with intramuscular Clindamycin for 7 days. When we consulted the patient with her previous doctor and nurse, we learnt that multiple daily injections might be injected to same side of left thigh. MRI showed a partial tear of vastus lateralis muscle matching with the injection sites. The patient treated with long leg half-casting for three weeks. Clinical examination and knee flexion had good results with conservative treatment.
Conclusions:
Multiple intramuscular injections may contribute to damage muscles and make prone to tears with muscle contractions. Doctors and nurses must be cautious to inject from different parts of both thighs.
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