Simultaneous bilateral rupture of the quadriceps has several causative pathogenetic factors. On the one hand there is diabetes with macro- and microangiopathy, on the other hand acute and chronic inflammatory processes such as spotted fever and leptospirosis, dysentery and hepatitis are worth mentioning. It is also interesting that the history contains statements on an Osgood-Schlatter disease in the left knee and a suspected meniscus lesion during the war years. The daily bending of the knee by this relatively old patient must be seen as a chronic lesion of over-strain.