(Fig 4-B.07) Dorsal Defect of the Patella

https://youtu.be/A_W31Pl1GcM

https://youtu.be/w63GyfUeIyw

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📌Dorsal Defect of the Patella

• The dorsal defect of the patella is generally considered a developmental anomaly of the epiphysis with delayed ossification.
• Despite its unclear (probably complex and multifactorial) etiology, the dorsal patellar defect does not grow in size and usually heals spontaneously with sclerosis, thus requiring no further intervention.

 

✅  Radiographic Appearance

• Lucent lesion with well-defined sclerotic borders at the superolateral aspect of the patella's dorsal articular surface

 

✅  MRI Appearance

• Well-defined lesion at the superolateral aspect of the dorsal patella
• Sclerotic margins with heterogeneous internal signal (isointense to hyperintense to cartilage)
• Intact overlying cartilage

 

✅  Symptomatic Lesions

Symptomatic dorsal defects may exhibit chondral irregularity and marrow edema.

 

✅  Differential Diagnosis

• Osteochondral injury
• Brodie's abscess
• Osteochondritis dissecans
• Neoplastic bony lesions
• Should not be mistaken for conditions like giant cell tumor, chondroblastoma, aneurysmal bone cyst, osteomyelitis, etc.

 

✅  Differentiating from Osteochondritis Dissecans

• Osteochondritis dissecans has a predilection for the medial facet of the patella
• May have a separated articular cartilage flap in osteochondritis dissecans
• Osteochondritis dissecans more commonly involves the central or superomedial aspect of the patella

 

References:

Skeletal Radiol (2016) 45:723-727 

Magn Reson Imaging Clin N Am 22 (2014) 601-620 

RadioGraphics 2018; 38:2069-2101 

Stoller's Orthopaedics and Sports Medicine, LWW, 2016 

Skeletal Radiol. 2018 Aug;47(8):1069-1086

 

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#DorsalDefectPatella, #DevelopmentalAnomaly, #DelayedOssification, #SclerolicLesion, #ChondralIrregularity, #MarrowEdema, #OsteochondritisDissecans, #DifferentialDiagnosis, #MusculoskeletalRadiology, #OrthopedicsRadiology