Presentation
Bilateral knee pain. No history of trauma.
Patient Data
Age: 7 years
Gender: Female
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Bilaterally, the primary ossification center of the patellae is small with irregular margins and a mottled appearance. There are areas of increased density and subtle fragmentation.
Case Discussion
Since its initial description by Köhler in 1908, osteonecrosis of the primary ossification center of the patella has been documented in a number of case reports. While bilateral disease was also reported, as in our case, the majority of case reports were in males with unilateral knee involvement. It can be asymptomatic or present with mild symptoms, in which case a high index of suspicion is required to diagnose.
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