The Pediatric Patella: Normal Development, Anatomical Variants and Malformations, Stability, Imaging, and Injury Patterns

Maloney, Ezekiel; Stanescu, A. Luana; Ngo, Anh-Vu; Parisi, Marguerite T.; Iyer, Ramesh S.

doi:10.1055/s-0037-1608004

Cited by 11 publications

(5 citation statements)

References 179 publications

(228 reference statements)

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“…26 For malignant tumours, there is destruction of bone, unclear margins, and pathological fractures on plain radiographs. 27 However, these results need to be considered with CT or magnetic resonance imaging results to accurately identify the surrounding lesions and tumour sites for diagnosis. 28 An accurate initial examination is important for therapy.…”

Section: Discussionmentioning

confidence: 99%

Oesophageal carcinoma with solitary patellar metastasis: a rare case report

et al. 2021

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The incidence of tumours found in the patella, including primary and metastatic tumours, is low. Solitary metastasis of oesophageal carcinoma (OC) in the patella is even rarer. A 50-year-old man presented to our clinic because of pain and limited range of motion in the right knee for 4 hours and after a fall. On the basis of the patient’s medical history, he was diagnosed with OC 2 months previously and underwent two cycles of paclitaxel liposome combined with tiggio chemotherapy (oral tiggio, 40 mg, two times/day, with a treatment cycle of 3 weeks). A 99mTc-methylene diphosphonate bone scintigraphy scan showed increased radioactivity in the right patella. A right knee biopsy showed the presence of patellar metastasis from OC. Unfortunately, the patient denied additional treatment and was discharged for personal reasons. At the 1-month follow-up, which was conducted by a telephone survey, we learned that the patient had died of acute pulmonary embolism. X-rays and computed tomography are useful for diagnosing patellar metastases, but 99mTc-methylene diphosphonate bone scintigraphy can help physicians diagnose patellar metastasis of OC more rapidly. Biopsy with pathology is the gold standard for diagnosing patellar metastases. Additionally, timely surgical treatment prolongs the survival time of these patients.

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Section: Discussionmentioning

confidence: 99%

Oesophageal carcinoma with solitary patellar metastasis: a rare case report

et al. 2021

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“…Avulsion fractures of the tibial eminence are the most frequent avulsion fractures of the immature skeleton. These are common before the closure of the physeal growth plate that constitutes a point of weakness in situations of excessive traction from the anterior cruciate ligament (ACL) 30 (►Fig. 6).…”

Section: Avulsion Of the Tibial Eminencementioning

confidence: 99%

“…31 Radiographic assessment can be challenging. 30 A standard knee radiograph is recommended with lateral projection the key for diagnosis. 31…”

Section: Avulsion Of the Tibial Eminencementioning

confidence: 99%

Conventional Radiography Assessment of the Pediatric Knee: Pearls and Pitfalls

Simoni,

Boitsios,

Saliba

et al. 2024

Semin Musculoskelet Radiol

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Knee pain is one of the most common indications for radiography in the evaluation of musculoskeletal disorders in children and adolescents. According to international guidelines, knee radiographs should be obtained when there is the suspicion of an effusion, limited motion, pain to palpation, inability to bear weight, mechanical symptoms (such as “locking”), and persistent knee pain after therapy. When indicated, radiographs can provide crucial information for the clinical decision-making process. Because of the developmental changes occurring in the knee during growth, the assessment of knee radiographs can be challenging in children and adolescents. Radiologists unfamiliar with the appearance of the knee on radiographs during skeletal maturation risk overcalling or overlooking bone lesions. Image acquisition techniques and parameters should be adapted to children. This article describes the most common challenges in distinguishing pathology from the normal appearance of knee radiographs in the pediatric population, offering some pearls and pitfalls that can be useful in clinical practice.

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“…48,49 The presence of trochlear dysplasia is the strongest risk factor for recurrent patellar instability following an initial dislocation event. 50,51 Trochlear dysplasia can be evaluated using both subjective (categorical classification systems) and objective (quantitative) measurements. Although a complete and comprehensive review is beyond the scope of this article, a few more common clinically utilized systems and measurements are highlighted.…”

Section: Variant Trochlear Morphologymentioning

confidence: 99%

Imaging of the Pediatric Knee

Yaya-Quezada,

Fanney,

Patel

et al. 2024

Semin Musculoskelet Radiol

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During normal development, imaging findings in the immature knee joint may mimic pathology or indicate transient sites of weakness, prone to injury. This article reviews the development of the knee joint, age- and maturation-dependent imaging considerations, and various developmental variants that can be encountered, subdivided into those that involve the tibiofemoral and patellofemoral compartments, soft tissues, and osseous components. The tibiofemoral compartment section reviews the focal periphyseal edema zone (FOPE), ossification variants of the femoral condyles, distal femoral metaphyseal cortical irregularity from periosteal traction, and the metaphyseal subperiosteal stripe, which should be distinguished from pathologic mimickers such as endochondral ossification dysfunction, osteochondritis dissecans (OCD), fibroosseous lesion, periosteal and subcortical pathologies. The patellofemoral compartment section includes a review of partite patella, dorsolateral defect, variant trochlear morphology, and maturation-dependent sites of transient weakness that are prone to injury from repetitive overuse (Sinding-Larsen-Johansson syndrome and Osgood-Schlatter disease) and avulsion fractures (patellar sleeve and tibial tubercle avulsions). Finally, soft tissue (discoid lateral meniscus, meniscal flounce, anterior cruciate ligament variants) and osseous components (meniscal ossicle, fabella, and cyamella) are reviewed.

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The Pediatric Patella: Normal Development, Anatomical Variants and Malformations, Stability, Imaging, and Injury Patterns

Cited by 11 publications

References 179 publications

Oesophageal carcinoma with solitary patellar metastasis: a rare case report

Oesophageal carcinoma with solitary patellar metastasis: a rare case report

Conventional Radiography Assessment of the Pediatric Knee: Pearls and Pitfalls

Imaging of the Pediatric Knee

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