There is a smoothly corticated ossicle adjoining a defect in the patellar outline along its superolateral border.
There is a smoothly corticated ossicle adjoining a defect in the superolateral border of the patella
There is a smoothly corticated ossicle adjoining a defect in the superolateral border of the patella

bipartite patella

By Jeff Thompson


History: N/A


Findings:

X-Ray 1: There is a smoothly corticated ossicle adjoining a defect in the patellar outline along its superolateral border. :: X-Ray 1 ::
There is a smoothly corticated ossicle adjoining a defect in the patellar outline along its superolateral border.







X-Ray 2: There is a smoothly corticated ossicle adjoining a defect in the superolateral border of the patella :: X-Ray 2 ::
There is a smoothly corticated ossicle adjoining a defect in the superolateral border of the patella







X-Ray 3: There is a smoothly corticated ossicle adjoining a defect in the superolateral border of the patella :: X-Ray 3 ::
There is a smoothly corticated ossicle adjoining a defect in the superolateral border of the patella









Discussion:

Bipartite patella is a congenital anomaly characterized by a local  defect in the expected outline of the patella with one or more separate ossification centers that are typically joined to the patella with fibrocartilage or other connective tissue. Estimates for incidence of this condition vary from less than 1% to 6%.  The superolateral portioin of the patella is  most often affected, followed in decreasing order by the lateral and inferior areas,  Bilateral presentation is typical (50-80%), which may be useful is there is differential consideration for a fracture, although sclerotic and often smooth margins of adjoining surfaces usually rules out acute fracture.  Diagnosis is made radiographically, often as an incidental findiing.  Symptoms are uncommon, but inflammation of the unossified tissue from repetitive stress or acute trauma may create symptoms.  Surgical removal of the separate ossicle(s) or lysing the individual quadiceps fibers that attach to them is considered only when conservative management fails.  





Differential diagnosis: N/A

Diagnosis confirmation: Imaging including endoscopy



Category: Musculoskeletal

Region / Organ: Leg-Bones

Etiology: congenital

References:
LINK http;//www.ncbi.nlm.nih.gov/pmc/articles/PMC2565028/
Clin Orthop Relat Res. 2008 November; 466(11): 2848�2855.

J Am Acad Orthop Surg. 2008 Aug;16(8):455-61.
Symptomatic bipartite patella: treatment alternatives.
Atesok K, Doral MN, Lowe J, Finsterbush A.
SourceSt. Michael s Hospital Musculoskeletal Research Lab, Toronto, Ontario, Canada

Published online 2008 July 8. doi: Excision of Painful Bipartite Patella: Good Long-term Outcome in Young Adults
Maria Weckstr�m, MD,1,2 Mickael Parviainen, MD,2 and Harri K. Pihlajam�ki, MD, PhD2,3




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