Patellar tendiopathy due to gross patella alta

Case contributed by Dr. Chris O'Donnell

Presentation

Acute knee pain following trauma. Longstanding anterior knee pain.

Patient Data

Age: 25 years
Gender: Male

Gross patella alta with articulation of the patellar tendon (rather than the patella) with a shallow femoral trochlea leading to patellar tendinopathy (abnormal T2 signal). Insall-Salvati index of 1.7. Caton-Deschamps index of 1.8. Abnormal T2 signal is also seen in the medial femoral condyle due to direct traumatic impact leading to "bone bruising". 

Case Discussion

Patella alta leads to abnormal articulation of the patella with the femoral trochlea leading to anterior knee pain due to maltracking of the patella and the potential for lateral patellar dislocation.

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