Patella alta

Patella alta (or a high riding patella) describes a situation where the position of the patella is considered high. It may be idiopathic or may result secondary to a patellar tendon rupture


Several conditions are known to be associated with patella alta, including:

  • idiopathic retropatellar pain 5
  • recurrent dislocation of the patella 2
  • chondromalacia patellae 2
  • knee joint effusion 2

Patella alta may also occur as a result of spastic cerebral palsy 6.

Radiographic features

On sagittal images, it is usually considered when the Insall-Salvati ratio is greater than 1.3-1.5 1-3.

On radiography, it is important that standard positioning is used, with the knee flexed at 30 degrees. An off-angle x-ray beam or nonstandard positioning may result in a spuriously abnormal ratio.

Knee pathology

The knee is a complex synovial joint that can be affected by a range of pathologies:

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