Presentation
Knee pain
Patient Data
There is marrow edema within the anterolateral aspect of the lateral femoral condyle, and medial patellar facet. This pattern of bone contusion is consistent with a transient lateral patellar dislocation injury. There remains minor lateral subluxation of the patella.
There are 2 fracture fragments adjacent to the lateral femoral condyle, which measure 12 x 5 mm and 19 x 4 mm. The more superior fracture fragment is horizontally flipped. There are also 2 osteochondral fracture fragments adjacent to the medial patellar facet, which measure 5 x 10 mm and 4 x 7 mm.
There is associated high-grade partial thickness tear of medial patellofemoral ligament at its patellar insertion. There are some intact residual fibers noted. No patella alta. No clear evidence of trochlea dysplasia. There is high signal and thickening of the patella tendon insertion on the tibial tuberosity.
There is associated bony spurring of the tibial tuberosity. The medial meniscus and MCL are intact. The lateral meniscus, iliotibial band, fibular collateral ligament, biceps femoris tendon and popliteus tendon are intact. Moderate knee joint effusion.
Case Discussion
Transient lateral patellar dislocation injury, with fractures of the anterolateral aspect of the lateral femoral condyle and osteochondral fractures of the medial patellar facet. No patellar alta or evidence of significant trochlear dysplasia.
Patellar tendon insertion high signal and thickening is likely unrelated to the acute injury and is more likely secondary to chronic avulsion injury Osgood-Schlatter's disease.
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