Anterior knee pain that originates at the front of the knee joint is a common complaint. Bipartite patella symptoms, treatment, surgery, recovery. Bipartite patella is commonly asymptomatic and often an incidental finding on radiological imaging. Symptomatic congenital bipartite patella is an uncommon pathology. The kneecap is embedded in the tendon tissue of the quadriceps femoris, a large thigh muscle. A patient often receives a diagnosis of bipartite patella when the knee is xrayed for some other reason.
Bipartite patella almost always affects the upper outer pole of patella. Of the 18 with no edema an alternative explanation for knee pain was found in 72%. The developing patella that matures from two centers rather than one. Purpose bipartite patella is a known cause of anterior knee bone marrow edema within the bipartite fragment was the pain. Aug 19, 2019 a bipartite patella occurs when the patella, or kneecap, occurs as two separate bones. Youll learn what it is, why it occurs, what types there are, and two major ways by which it can be treated. A bipartite patella occurs when the patella, or kneecap, occurs as two separate bones. An awardwinning, radiologic teaching site for medical students and those starting out in radiology focusing on chest, gi, cardiac and musculoskeletal diseases containing hundreds of lectures, quizzes, handout notes, interactive material, most commons lists and pictorial differential diagnoses. Efficacy of surgical interventions for a bipartite patella. Bipartite patella is a congenital condition present at birth that occurs when the patella kneecap is made of two bones instead of a single bone. Oct 30, 2017 a bipartite patella is a kneecap thats made up of two bones instead of the usual one. Bipartite patella article about bipartite patella by the. A patients guide to bipartite patella introduction.
Instead of fusing together in early childhood, the bones of the patella remain separated. Prevalence of bipartite patella in turkish population. Bipartite patella bp is developmental abnormality where failure of the ossification centers to unite results in a fibrocartilaginous union between the bipartite fragment and the patella body. Presentation1, radiological imaging of anterior knee pain. Bipartite patella is often confused with a patellar fracture. Although usually an incidental finding on xray, around 2% can become painful, usually after trauma or participation in sports and more commonly in young adults. Feb 07, 2017 bipartite patella is a congenital condition in which the patella is actually two separate bones, not one, as is usually the case. Instead of fusing together in early childhood, the patella remains separated. Bipartite patella is a condition where the patella, is composed of two separate bones. Most of these ossification centers fuse mutually, but approximately 2% of them remain to be dissociated 2,3 although bipartite patella is. Bipartite patella is usually incidental and asymptomatic, but recent literature suggests rare pain syndromes due to this variant. Bipartite patella is usually seen at the superolateral edge of the patella and is unilateral in 57% and bilateral in the remainder, with a male. Like most bones the patella forms from multiple centres of ossification ogden ja radiology of.
Successful treatment of painful synchondrosis of bipartite. Our purpose was to detail the magnetic resonance sole finding on knee mri in almost half of the patients in imaging mri features of bipartite patella in a retrospec our series. A gallery of normal anatomical variants for radiology trainees revising for the first. Patella or the kneecap is present in front of the knee. First described in 1883 by gruber, this anatomic variant was classified by saupe in 1921 and later reclassified in 2010 by oohashi et al. This lesson describes a relatively uncommon condition known as bipartite patella. Bipartite patella is normally a benign condition in which the patella is formed of two bones instead of one bone which is the norm for everyone.
Multipartite patella is an uncommon congenital abnormality that represents normal variant pathology and is a result of a failure of ossification during development. Central and medial components of the quad tendon and patella. Clinical features and classification of bipartite or. It is most commonly diagnosed as an incidental finding. Department of radiology, richmond university medical center, 355 bard ave. The bipartite medial cuneiform was detected by computed tomography that was performed to assess for fracture of the intermediate cuneiform. Aug 02, 2017 minitalk about a case of bipartite patella, and facrts with ct and knee xray example hopping you like it dr hisham alkhatib consultant radiologist. Hi dear, bipartite patella occurs when the patella, or kneecap, occurs as two separate bones. Anterior knee pain, bipartite patella, synchondrosis. Our purpose was to detail the magnetic resonance imaging mri features of bipartite patella in a retrospective cohort of patients imaged at our institution. Bipartite patella fracture is an uncommon injury that has rarely been described in the literature. Bipartite patella usually affects both knees when they take an xray of the other knee it will show the same medical condition. Normally, the two bones would fuse together as the you grow.
Hing abstract purpose this study aimed to identify the most effective method for the treatment of the symptomatic bipartite patella. Bipartite patella is a known cause of anterior knee pain. This can lead to inflammation and an mri finding of bone marrow. Pdf contemporary management of symptomatic bipartite patella. Oneal et al 2 described the presence of a bipartite medial cuneiform in a 5yearold boys amputated leg.
The result is a bipartite or tripartite patella and this affects around 12% of the population. Bipartite patella a normal variant is often confused with a fractured patella. Contemporary management of symptomatic bipartite patella. Of the 53 patients with bipartite patella 40 75% were male. The ununited center is almost always in the upper outer quadrant of the patella. A bipartite or multipartite patella is estimated to have a prevalence of 0. The purpose of our study was to describe the magnetic resonance imaging mri features of bipartite patella in asymptomatic patients.
Epidemiology the superolateral accessory ossification center of the patella is usually present by 12 years of age and. Jul 08, 2008 the bipartite patella was first described by gruber in 1883, and much has been added to our knowledge of this chondroosseous disruption of the patella since then 8, 15, 24, 25, 28, 29. Case of the week 275 on awardwinning, radiologic teaching site for medical students and those starting out in radiology focusing on chest, gi, cardiac and musculoskeletal diseases containing over 200 powerpoint lectures, quizzes, handout notes, interactive material, most commons lists and pictorial differential diagnoses. It can be quite debilitating in the competitive athlete and is often overlooked by the treating physician. A bipartite patella is a kneecap thats made up of two bones instead of the usual one. A gallery of normal anatomical variants for trainees revising for the first frcr anatomy exam a normal variant is an atypical finding that is seen in a percentage of the population, which generally has no clinical significance, and is considered within the spectrum of normal findings. This process is experimental and the keywords may be updated as the learning algorithm improves. The sciatic nerve arises from the through spinal nerve roots, passes through the sciatic notch in the pelvis, and runs down the back of the leg where it divides into the tibial and common fibular nerves. Bipartite patella definition of bipartite patella by. Key pointswell corticated fragmentusual location superolateral pole of the patella. Bipartite patella occur most commonly in the superior lateral location, 75% of cases. This usually congenital condition causes no symptoms but may be mistaken for a fracture. Kavanagh ec1, zoga a, omar i, ford s, schweitzer m, eustace s. Frontal and lateral radiographs of the patella demonstrate a transverse fracture through the midpole of the patella with displacement.
Bipartite scaphoid radiology case contributed by dr. May 25, 2009 bipartite patella is an accessory ossification center of the patella that does not fuse to the primary patella. A bipartite patella forms when a portion of the patella does not completely heal along. The most common type of segmentation results in separation of the upper outer quadrant which is called bipartite patella. The superolateral accessory ossification center of the patella is usually present by 12 years of age and may persist into adult life.
It is frequently bilateral in distribution and can be a cause of pain if there is disruption of its synchondrosis. Symptomatic bipartite patella is uncommon, and to ensure good outcome, patient selection is the key. Pdf efficacy of surgical interventions for a bipartite patella. On plain radiographs, the margins are smooth and corticated. Doctors estimate that approximately 1 percent of the population experiences this condition, but the number may be higher because the condition is typically asymptomatic. Bipartite patella is a condition where the patella, or kneecap, is composed of two separate bones. Frontal and lateral radiographs of the patella demonstrate a transverse fracture through the midpole of the patella with displacement of the superior pole red arrow by the quadriceps tendon and displacement of the inferior pole red arrow by the patellar tendon black arrows. Mri exams from 53 patients with findings of bipartite patella were evaluated to assess for the presence of bone marrow edema within the bipartite fragment and for the presence of. A bipartite or multipartite patella a normal patellar variant is found in 2% to 6% of the population 1 and results from developmental union failure of 1 or more accessory ossification centers. This page includes the following topics and synonyms. The cause is incomplete fusion of the ossification centers of the patella. A patients guide to bipartite patella in children compliments of. The patella is the bodys largest sesamoid and lies in the quadriceps tendon. Treatment of symptomatic bipartite patella west indies.
If patellar debridement performed by open px, also it has descriptor of patellectomy means surgical removal of patella or kneecap. But in bipartite patella, they remain as two separate bones. The smaller part is a separate ossification centre and is most commonly located superiorly and laterally as in this case. A bipartite patella twopart patella is a patella with an unfused accessory ossification center at the superolateral aspect. Learn more about this rare condition and how to manage it. Bipartite patella separation and partial quadriceps tendon rupture in. A bipartite patella is a result of failure of fusion of a secondary ossification center and should not be mistaken for an acute fracture. Mri exams from 53 patients with findings of bipartite patella were evaluated to assess for the presence of bone marrow edema within the bipartite fragment. Bipartite patella is an accessory ossification center of the patella that does not fuse to the primary patella. Thus, on an mri scan, there should not be any increased signal between the. Jul 04, 2019 bipartite patella normally is diagnosed incidentally when radiological studies are done of the knee region for some other reason. Mri findings in bipartite patella mri findings in bipartite patella kavanagh, eoin.
A classification system according to saupe 12 is based on location. Consider bilateal knee xray expect both patellas to be bipartite. The most common location of the second bone is the superolateral upper outer corner of the patella. Bipartite patella separation and partial quadriceps tendon rupture in the setting of trauma.
More rarely, there may be a third segment resulting in a tripartite patella. Most bipartite patellae are asymptomatic and a clinically. Segmentation of the patella occurs when there is a failure of fusion of the ossification centers in early childhood. Generally, individuals do not know that they have the disorder. The bipartite patella is a developmental osseous variant that is found in approximately 2% to 6% of the population, and is bilateral in 50%.
The first author prospectively examined 111 patients with symptomatic or asymptomatic bipartite 1 knees or. This mri newsletter is published on radius imaging on mr of. The condition occurs in approximately 12% of the population and is no more likely to occur in males than females. This usually congenital condition causes no symptoms but may be mistaken for a. The tibia and fibula are facing the viewer on this lateral image of the knee indicating marked rotational displacement.
This disorder has a profound economic and social impact as it affects approximately 1533% of young and active people. It is often asymptomatic and most commonly diagnosed. Europe pmc is an elixir core data resource learn more. Bipartite patella is a condition that affects the patella, or kneecap. Instead of fusing together as normally occurs in early childhood, the bones of the patella remain separated.
Edema within the bipartite fragment was the sole finding in 26 of 53 49% patients presenting with knee pain. Surgical technique for arthroscopic resection of painful. Bipartite patella results from congenital fragmentation of the patella. Prevalence of a bipartite patella occurs in approximately 2% of the population. The purposes of this study were to report clinical features of the developmental anomaly of ossification type bipartite or tripartite patella using a large series and to propose a new classification for the developmental anomaly of ossification type bipartite or tripartite patella. A patients guide to bipartite patella compliments of. Bipartite patella separation and partial quadriceps tendon. Know the causes, symptoms, treatment and recovery period. The bipartite patella is a normal patellar variant secondary to failure of fusion. Patella is the largest sesamoid bone which ossifies from one center in 77% and from two or three centers in 23% of children 1. The bipartite patella was first described by gruber in 1883, and much has been added to our knowledge of this chondroosseous disruption of the patella since then 8, 15, 24, 25, 28, 29.
Ogden ja, mccarthy sm, jokl p 1982 the painful bipartite patella. Occasionally, bipartite patella can become painful through. Bipartite patella occurs in 8% of the population, is much more common in males 9. Our purpose was to detail the magnetic resonance sole.
The first author prospectively examined 111 patients with symptomatic or asymptomatic. Xrays show a bipartite patellar defect and round ossific body superiorly. Successful treatment of painful synchondrosis of bipartite patella. Analysis of bilateral knee radiographs in 897 subjects. Congenital and developmental abnormalities of the knee. Injury or direct trauma to the synchondrosis can cause a separation of this weak union. Nutrient channels or canals run diagonally only in. But the problem can occur at the bottom of the patella or along the side of the kneecap.
Jan 29, 2010 the purposes of this study were to report clinical features of the developmental anomaly of ossification type bipartite or tripartite patella using a large series and to propose a new classification for the developmental anomaly of ossification type bipartite or tripartite patella. Bipartite patella as seen on an axial mri normal variant. Bipartite patella knee pain knee specialist minnesota. Bipartite patella is usually asymptomatic and is an incidental finding on radiographs. Bipartite patellacausessymptomstreatmentrecovery period. The study was prospective in type and performed following. A bipartite patellacan be seen in up to 2% of the population. Mostly assigning the pain origin to the nonfused fragment is easy though, in few cases, can be a serious dilemma, especially in the absence of direct tenderness over nonfused fragment. Treatment most of the time there is no treatment necessary but if you start to have symptoms you may need to have it treated. Introduction bipartite patella is a congenital condi tion present at birth that occurs when the patella kneecap is made of two bones instead of a single bone. A bone scan can be helpful in confirming the diagnosis, and appropriate treatment often results in a successful outcome. Mri shows the bony body attached to the vastus lateralis fibers of the quad tendon. The bone of the patella knee cap forms in cartilage of the foetal skeleton.
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