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Quadriceps muscle lesion
 It can be a tenoperiostal lesion (supra-, infra-, or parapatellar) or a muscle belly lesion.
Both clinical image and treatment are different. An acute muscle belly lesion can cause muscular spasm, thus also limiting some passive movement (knee flexion).
Active treatment (e.g. deep transverse friction massage)should be combined with relative rest.
Minor rupture in the quadriceps muscle belly
Pain appearing suddenly while running or jumping. A haematoma may be present. Resisted extension is painful, or painful and weak, and passive flexion is painfully limited, particularly in prone-lying. On palpation, there is local tenderness, possibly with a palpable gap.
Quadriceps tendinitis
Resited extension is painful, passive flexion is not limited and there is local tenderness. The lesion can lie at one of four sites : supra-, infra- and parapatellar (medial or lateral), all at the tenoperiosteal junction.
Infrapatellar tendinitis is very frequently seen in jumpers.
Walking upstairs and standing after sitting a while is painful as well.
Different stages are described :
stage I : pain after activity
stage II : pain at the start of the activity, better during activity and afterwards worse again
stage III : constant pain, no activity possible
stage IV : rupture resulting in weakness.
(Part I, p135-136 ; Part II, p31-32)
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