(Fig 4-B.05) Patellar Comparison/ Multipartite, Bipartite, Vertical Fracture

https://youtu.be/7Y-Kg4oECIY

https://youtu.be/w63GyfUeIyw

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📌 Differentiating Bipartite and Multipartite Patella from Fractures

• A bipartite or multipartite patella, which involves the presence of more than one ossicle or bone fragment, may be mistaken for a fracture. However, it can usually be distinguished from a fracture by the following features:

 

1️⃣ Typical Location: 

• Bipartite and multipartite patellae tend to occur in specific locations, such as the superolateral pole or lateral margin.

 

2️⃣ Well-Corticated Margins: 

The ossicles or fragments in bipartite and multipartite patellae often have well-corticated margins, indicating a developmental process rather than a recent fracture.

 

3️⃣ Articular Cartilage Integrity: 

The articular cartilage of the bipartite segment remains intact, unlike in fractures where the cartilage may be disrupted.

 

4️⃣ Normal Marrow Signal: 

• The ossicles or fragments should exhibit normal marrow signal, unlike fracture fragments, which may show bone marrow edema or abnormal signal.

 

5️⃣ Smooth Synchondrosis: 

• The synchondrosis, or the junction between the ossicles, should appear smooth and show normal cartilage signal.

 

6️⃣ Osseous or Fibrous Union: 

• Bipartite and multipartite patellae may demonstrate osseous or fibrous union between the ossicles, which is not seen in fractures.

 

7️⃣ Hypertrophy of Unfused Fragments: 

• Accessory ossification centers in multipartite patellae can be distinguished from fracture fragments by recognizing the hypertrophy of the unfused fragments and their corticated margins.

 

8️⃣ Fragment Size: 

• In bipartite patellae, the bipartite segment is often larger than expected for a fracture fragment.

 

References:

• Skeletal Radiol. 2018 Aug;47(8):1069-1086
• Magn Reson Imaging Clin N Am 22 (2014) 601–620
• RadioGraphics 2018; 38:2069–2101

 

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 #BipartitePatella, #MultipartitePatella, #PatellarFracture, #OssicleHypertrophy, #CorticatedMargins, #CartilageIntegrity, #NormalMarrowSignal, #SmoothSynchondrosis, #OssificationCenters, #FragmentSize.