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Clinical Image - International Journal of Clinical & Medical Images (2024) Volume 11, Issue 3
Author(s): Marrakchi Salma*, Laasri Khadija, El Yousfi Zakia, Hadj Hsain Ihssan, Laamrani Fatima Zahrae, Jroundi Laila and El Aoufir Omar
Department of Emergency Radiology, Ibn Sina University Hospital, Rabat, Morocco
Received: 27 October 2023, Manuscript No. ijcmi-23-118600; Editor assigned: 28 October 2023, Pre QC No. P-118600; Reviewed: 15 March 2024, QC No. Q-118600; Revised: 21 March 2024, Manuscript No. R-118600; Published: 29 March 2024, DOI:10.4172/2376-0249.1000948
Citation: Salma M, Khadija L, Zakia EIY, Ihssan HH and Fatima L, et al. (2024) What can mimic a Patellar Fracture?. Int J Clin Med Imaging 11: 948.
Copyright: © 2024 Salma M, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Bipartite patella is a patella with an unfused accessory ossification center, typically at the superolateral portion of the patella, it is a congenital knee condition considered as a normal variant of the patella, it is often an incidental finding on radiographs as the condition is usually asymptomatic. On radiographic examination it appears as an unfused patella most commonly at the superolateral pole, mimicking a patellar fracture.
The patella is the largest sesamoid bone in human body which plays an important role in knee biomechanics [1]. Often confused with patella fractures, bipartite patella is a patella with an unfused accessory ossification center, typically at the superolateral portion of the patella [2]. It is a congenital knee condition considered as a normal variant of the patella, which is caused by the failure of the patella to fuse during growth. It occurs in 1 to 2% of the population, and can be bilateral in about 43% of cases. It seems to be more common in males than in females [3]. It is often an incidental finding on radiographs as the condition is usually asymptomatic. It may be symptomatic in 2% of cases and cause anterior knee pain, especially after trauma, sports injury, or overuse [2].
On radiographic examination it appears as an unfused patella most commonly at the superolateral pole, mimicking a patellar fracture except that the context of discovery is often non-traumatic.
The location at the superolateral portion of the patella, smooth margin without sclerotic changes, and lack of joint or soft tissue effusion help to confirm that this is not a fracture.
Saupe [4] classified bipartite patella into three types depending on the localization of the unfused fragment of patella.
Type I: (5%), the fragment is localized in the inferior pole.
Type II: (20%), the fragment is localized at the lateral margin.
Type III: (75%) the fragment is localized at the supero-lateral portion of patella.
Medial bipartite patella is exceptional [1].
In the majority of cases, symptomatic bipartite patella improves without surgery. Surgical excision of the small fragment is recommended if conservative management fails and has been reported to give good results [5].
Bipartite patella; Radiograph; Anterior knee pain
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[1] Zabierek S, Zabierek J, Kwapisz A and Domzalski ME. (2016). Bipartite patella in 35-year-old fitness instructor: A case report. Int J Sports Phys Ther 11(5): 777.
[2] Radswiki T, Weerakkody Y and Knipe H. Bipartite patella.
[3] Rich J, Dea DE and Powers RH. (2007). Forensic medicine of the lower extremity. Springer Science & Business Media.
[4] Saupe H. (1943). Primäre knochenmarkseiterung der kniescheibe. Ger J Surg 258: 386-392.
[5] Atesok K, Doral NM, Lowe J and Finsterbush A. (2008). Symptomatic bipartite patella: Treatment alternatives. J Am Acad Orthop Surg 16(8): 455-461.
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