Tripped over a construction cable while walking causing him to fall directly onto his right knee. Patient presented with progressive swelling and pain and only able to partially weight bear. Physical Examination - pre-patellar swelling with minimal tenderness to medial aspect of knee and patella with limited active/passive range of movement.
Right knee joint
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Nil acute bony injury. A linear lucency noted to the lateral aspect of the patella in keeping with a bipartite patella.
A bipartite patella (two-part patella) is a patella with an unfused accessory ossification center. It is usually discovered incidentally. However, 2% of patients with bipartite patella experience symptoms such as anterior knee pain, especially after trauma (as with this patient), sports injury, or overuse.
There are three types of Bipartite Patella:-
- type I: inferior pole ~1%
- type II: lateral margin ~20-25%
- type III: superolateral portion ~75% (as with this patient)
- 1. Zabierek S, Zabierek J, Kwapisz A, Domzalski ME. BIPARTITE PATELLA IN 35-YEAR-OLD FITNESS INSTRUCTOR: A CASE REPORT. (2016) International journal of sports physical therapy. 11 (5): 777-783. Pubmed
- 2. https://www.orthobullets.com/pediatrics/4049/bipartite-patella