Knee pain post fall.
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Alignment is normal. No fracture identified. (The lateral was normal, without evidence of joint effusion.)
Incidental tripartite patella, a normal anatomic variant.
With a multipartite patella, the volume of the true patella plus that of the smaller ossification centers is greater than that expected of a normal patella. The DDx is obviously a patellar fracture, where the volume of the fractured components is equivalent to that of a normal patella.