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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
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