What’s the Diagnosis – Case 185 1
What’s the Diagnosis – Case 185 2
What’s the Diagnosis – Case 185 3
What’s the Diagnosis – Case 185 4
What’s the Diagnosis – Case 185 5
What’s the Diagnosis – Case 185 6
What’s the Diagnosis – Case 185 7
What’s the Diagnosis – Case 185 8
What’s the Diagnosis – Case 185 9
What’s the Diagnosis – Case 185 10
What’s the Diagnosis – Case 185 11
What’s the Diagnosis – Case 185 12
What’s the Diagnosis – Case 185 13
What’s the Diagnosis – Case 185 14
What’s the Diagnosis – Case 185 15
What’s the Diagnosis – Case 185 16
What’s the Diagnosis – Case 185 17
What’s the Diagnosis – Case 185 18
What’s the Diagnosis – Case 185 19
What’s the Diagnosis – Case 185 20
What’s the Diagnosis – Case 185 21
What’s the Diagnosis – Case 185 22
What’s the Diagnosis – Case 185 23
What’s the Diagnosis – Case 185 24
What’s the Diagnosis – Case 185 25
What’s the Diagnosis – Case 185 26
What’s the Diagnosis – Case 185 27
What’s the Diagnosis – Case 185 28
What’s the Diagnosis – Case 185 29
What’s the Diagnosis – Case 185 30
What’s the Diagnosis – Case 185 31
What’s the Diagnosis – Case 185 32
What’s the Diagnosis – Case 185 33
What’s the Diagnosis – Case 185 34
What’s the Diagnosis – Case 185 35
What’s the Diagnosis – Case 185 36
What’s the Diagnosis – Case 185 37
What’s the Diagnosis – Case 185 38
What’s the Diagnosis – Case 185 39
What’s the Diagnosis – Case 185 40
What’s the Diagnosis – Case 185 41
What’s the Diagnosis – Case 185 42
What’s the Diagnosis – Case 185 43
What’s the Diagnosis – Case 185 44
What’s the Diagnosis – Case 185 45
What’s the Diagnosis – Case 185 46
What’s the Diagnosis – Case 185 47
What’s the Diagnosis – Case 185 48
What’s the Diagnosis – Case 185 49
What’s the Diagnosis – Case 185 50
What’s the Diagnosis – Case 185 51
What’s the Diagnosis – Case 185 52
What’s the Diagnosis – Case 185 53
What’s the Diagnosis – Case 185 54
What’s the Diagnosis – Case 185 55
What’s the Diagnosis – Case 185 56
What’s the Diagnosis – Case 185 57
What’s the Diagnosis – Case 185 58
What’s the Diagnosis – Case 185 59
What’s the Diagnosis – Case 185 60
Findings
The cross-table lateral radiograph shows an elevated patella and a small bone fleck about the inferior pole of the patella. Noted on the AP radiograph is a bipartite patella with a slightly less common lateral bipartite component as compared to the more common superolateral component. The MRI shows a complex disruption of the patella tendon where the lateral 1/3 from the bipartite component is disrupted distally and now insinuates into a proximal disruption of the medial 2/3. There is also disruption of the medial and lateral retinacular tissues.
What’s the Diagnosis – Case 185
61
What’s the Diagnosis – Case 185 62
What’s the Diagnosis – Case 185 63
What’s the Diagnosis – Case 185 64
What’s the Diagnosis – Case 185 65
What’s the Diagnosis – Case 185 66
What’s the Diagnosis – Case 185 67
What’s the Diagnosis – Case 185 68
What’s the Diagnosis – Case 185 69
What’s the Diagnosis – Case 185 70
What’s the Diagnosis – Case 185 71
What’s the Diagnosis – Case 185 72
What’s the Diagnosis – Case 185 73
What’s the Diagnosis – Case 185 74
What’s the Diagnosis – Case 185 75
What’s the Diagnosis – Case 185 76
What’s the Diagnosis – Case 185 77
What’s the Diagnosis – Case 185 78
What’s the Diagnosis – Case 185 79
What’s the Diagnosis – Case 185 80
What’s the Diagnosis – Case 185 81
What’s the Diagnosis – Case 185 82
What’s the Diagnosis – Case 185 83
What’s the Diagnosis – Case 185 84
What’s the Diagnosis – Case 185 85
What’s the Diagnosis – Case 185 86
What’s the Diagnosis – Case 185 87
What’s the Diagnosis – Case 185 88
What’s the Diagnosis – Case 185 89
What’s the Diagnosis – Case 185 90
What’s the Diagnosis – Case 185 91
What’s the Diagnosis – Case 185 92
What’s the Diagnosis – Case 185 93
What’s the Diagnosis – Case 185 94
What’s the Diagnosis – Case 185 95
Diagnosis: Patellar Tendon Avulsion
Although this was not a particularly big diagnostic dilemma on imaging and likely would not be that difficult of a clinical diagnosis, I think the case still demonstrates that imaging can be very helpful even in situations where the diagnosis may be straight forward. The complexity of this tear with proximal and distal components and the insinuated architecture of one portion of the tendon into the other may be very complicated to appreciate at the time of surgery. Having good preoperative imaging in this case allowed a thorough understanding of the tear pattern and helped the surgeon in planning for the case as well as performing the appropriate, excellent repair.
What’s the Diagnosis – Case 185
96
What’s the Diagnosis – Case 185 97
