Traumatic prepatellar quadriceps continuation injury in an elite cyclist

Injury to the prepatellar quadriceps continuation is a lesser recognized extensor mechanism injury when compared to the more commonly encountered quadriceps and patellar tendon injuries. We present a case of a traumatic injury to the prepatellar quadriceps continuation in an elite cyclist without injury to the adjacent patellar or quadriceps tendons. The magnetic resonance imaging findings depict the anatomy of the prepatellar structures in detail, as well as the sequelae of trauma. These include, but are not limited to partial or complete tearing, stripping and elevation of the anterior surface of the patella, and traumatic reactive prepatellar bursitis. Cyclists may be predisposed to injury to the prepatellar quadriceps continuation due to background overuse prepatellar friction syndrome, but as in our case, injury can also be the result of an acute traumatic insult. These injuries can be managed conservatively with physiotherapy and result in a good outcome.