Diagnosing a Quadricep Strain
To help your doctor achieve a proper diagnosis, he/she will begin with a medical history about you, your current condition and symptoms. He/she will inquire about the intensity of your present pain, if you heard a popping noise when you first experienced your injury, the duration and type of symptoms and the limitations you are experiencing. Details about what instigated your problem, when it started, and whether or not you have ever had treatments for this or a similar condition in the past, will be very helpful in assessing your injury.
A physical examination will be performed to determine if you have any signs of a quadriceps strain. Your doctor will visually assess and feel the muscles, bones and other soft tissue in and around your quadriceps, as well as your entire leg/knee, pelvis and lower back, to evaluate sameness (symmetry), recognize differences and identify pain and tenderness. This will help to discover any abnormalities, such as mild or severe inflammation, fluid, bruising, bone or tissue deformity, and leg length discrepancies. He/she may ask you to complete a series of flexing and extending leg movements to see what motions cause pain, weakness, tightness, or instability. This will help to determine the location of your injury (in the muscle belly or near the attachment), test for the grade of your quadriceps strain and any muscle imbalances. Generally with a strain you will experience resisted extension and pain, where as with a tear you will not be able to complete a straight leg raise. He/she will also evaluate your feet and gait (the way you walk) to determine if you overpronate, or have other alignment issues.
Most Common Quadriceps Injury Diagnostic Tests:
Most grade 1 or 2 quadriceps strains don't require diagnostic testing, however these tests will help confirm if you have a grade 3 strain and/or will rule out other causes of quadriceps pain. The severity of quadriceps injuries can often be missed, hidden or underestimated because swelling and bleeding can occur deep within the muscle. Without a diagnostic test, it can be difficult to differentiate a fractured kneecap from a quadriceps tendon tear.
X-rays will provide a two-dimensional image of the overall structure of your quadriceps and upper leg (pelvis, femur and knee). They are helpful in identifying instability, fractures, abnormal bone shapes (bone spurs, calcifications or cysts, joint degeneration), and/or other leg problems.
MRIs (magnetic resonance imaging) will provide more detailed information and will help to evaluate the soft tissues in and around your quadriceps (muscles, tendons, ligaments, fascia, and other connective tissues). They can identify ligament or tendon damage, and can help to determine the extent of your injury, the grade of your tear, inflammation or tendinopathies, as well as other associated conditions.
CT scans (computed tomography) and ultrasounds have been also used on occasion.