Patellar ligament rupture

Case contributed by Dr Craig Hacking

Presentation

Pain and swelling after injury

Patient Data

Age: 56
Gender: Female
X-ray

There is a large knee joint effusion without lipohaemarthrosis. There is also significant soft tissue swelling within the prepatellar region. Small avulsion fracture of the inferior pole of the patella with superior displacement of the patella suggesting either a patellar tendon rupture or a patellar sleeve avulsion. A linear ossified fragment projected adjacent to the medial femoral condyle may represent a Pellegrini-Stieda lesion.

CT

The patellar tendon is ruptured at its upper margin. Small bony fragments in the anterolateral soft tissues is surrounded by a lot of soft tissue fluid are continuous with the upper torn margin of the patellar ligament (best seen in the axial soft tissue window) with a possible corresponding donor site on the inferolateral margin of the patella. This is in keeping with a patellar avulsion fracture.

There is a small cortical fracture demonstrated arising from the medial femoral condyle at the location of the MCL attachment with adjacent soft tissue edema and stranding.

There are is a large haemarthrosis.

There are moderate degenerative changes with osteophytic lipping.

Case Discussion

Pt was transferred to another center for surgery.

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Case information

rID: 40150
Case created: 9th Oct 2015
Last edited: 2nd Mar 2017
Inclusion in quiz mode: Included

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