Lateral patellar dislocation

Case contributed by Utkarsh Kabra
Diagnosis almost certain

Presentation

History of fall.

Patient Data

Age: 30 years
Gender: Female
mri

High grade tear of medial patellofemoral ligament in mid-segment and femoral attachment. Partial tear of patellar attachment of medial patellofemoral ligament is also seen.  

Lateral subluxation of patella is seen with lateral articular facet lying in close contact with lateral trochlear facet. Irregularity and hyperintensity are seen involving articular cartilage along lateral articular facet of patella. 

Bone contusion with surrounding marrow edema is seen involving inferior aspect of medial articular facet of patella. Hyperintensity is seen involving articular cartilage along medial articular facet of patella. 

Bone contusion with surrounding marrow edema is seen involving lateral aspect of lateral femoral condyle. 

Low grade sprain of anterior cruciate ligament is seen involving the posterolateral bundle in mid-segment and tibial attachment. Its continuity is maintained. 

Low grade sprain of femoral attachment and mid-segment of medial collateral ligament is seen. 

Significant edema is seen superficial to medial collateral ligament, almost along its entire extent. Mild edema is also seen along posteromedial joint capsule. 

Low grade sprain of femoral attachment of lateral collateral ligament is seen. 

Low grade strain of intracapsular segment of popliteus tendon is seen.

Mild strain of the mid-segment of ligamentum patellae and patellar attachment with soft tissue edema superficial to it.

Low grade strain of vastus medialis muscle is seen. 

Mild edema is seen in infrapatellar fat pad along inferior patellar plica. 

Wedge-shaped hyperintensity seen in posterior horn medial meniscus not intersecting with articular margins (Grade 2c meniscal tear) – likely meniscal degeneration/ intrasubstance tear not reaching up to surface. 

Moderate hemarthrosis is seen.

Case Discussion

Findings are suggestive of lateral patellar dislocation

  • Caton-Deschamps index ~ 0.9 (normal range 0.6 – 1.3)
  • shallow trochlear groove, Sulcal angle ~ 144O (mildly)
  • patellar type - Wiberg type II
  • distance from tibial tubercle to trochlear groove is ~ 15 mm (borderline)

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.