BILATERAL FRAGMENTED PATELLA-A NORMAL VARIANT OR PATHOLOGY? CASE REPORT

Pa, I Ta N J O U R N A L O F R A D I O, L Gy
unpublished
O s te och ondros is are s e l f-l im iting dis turbance s of e ndoch ondral os s ification ch aracte riz e d by radiol ogical fragm e ntation and s cl e ros is of th e invol ve d bone .Pre s e nting a cas e of 06 ye ars ol d girl w ith bil ate ral painful k ne e s and diagnos e d to h ave fragm e nte d pate l l ae. Keywords: os te och ondros is , pate l l a, ch il dre n, os s ification ce ntre. ABSTRACT Case Report A 6 ye ar ol d active f e m al e girl w it h no k now n com orbid pre s e nte d
more » ... orbid pre s e nte d to th e pe diatrician's O PD cl inic w ith 3 m onth s h is tory of pe rs is te nt bil ate ral k ne e pain. Sh e re porte d no pre vious h is tory of traum a. O n e xa-m ination s h e h ad m il d s w e l l ing of both k ne e s and w as te nde r to pal pation. Th e re w as no as s ociate d ove rl ying s k in re dne s s. AP and l ate ral X rays w e re done of both k ne e joints. Pl ain X rays re ve al e d fragm e nte d and m ottl e d appe arance of pate l l ae bil ate ral l y w ith irre gul ar m argins as s h ow n in (Fig. 1a and 1b). Re s t of th e bone s of th e k ne e joint s w e re norm al w ith norm al ove rl ying s oft tis s ue s. Fat pl ane s w e re intact. Afte r re vie w ing th e X rays it w as de cide d th at pl ain M RI of th e k ne e s h oul d be pe rf orm e d f or furth e r e val uat ion. Pl ain M RI of th e l e ft k ne e w as pe rform e d w ith w ate r s e ns itive s e q ue nce s. Th e MRI s h ow e d a fragm e nte d m ottl e d pate l l a w ith irre gul ar borde rs and l os s of norm al contour. It appe are d h e te roge ne ous on T2W I (Fig. 1c), h ypoint e ns e on T1W I (Fig. 1d), h ype rinte ns e Sumaira Babar, Shumaila Arooj, Tariq Mehmood De partm ant of Radiol ogy, Jinnah Pos t Graduat e M e dical Ce ntre (JPM C), K arach i, Pak is tan. PJR April-June 2015; 25(2): 70-72 Figure 1a & b: Pl ain X-rays re ve al e d fragm e nte d and m ottl e d appe arance of pate l l ae bil ate ral l y w ith irre gul ar m argins a b on coronal STIR im age s and h e te roge ne ous l y l ow on PD and h e te roge ne ous l y h ype rinte ns e on PD fat s at im age s. Th e re w as no joint e ffus ion. A final diagnos is of Koh l e r's of prim ary os s ification ce ntre Fig 1c(Axial T2WI) and 1d (Sagittal T1WI): Th e M RI s h ow e d a fragm e nte d m ottl e d pate l l a w ith irre gul ar borde rs and l os s of norm al cont our. It appe are d h e t e roge ne ous on T2W I, h ypointe ns e on T1W I w ith no joint e ffus ion. Axial T2WI Sagittal T1WI
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