Bipartite patella revisited: the not so asymptomatic accessory ossicle.

IF 2.3 3区医学 Q2 PEDIATRICS

Pediatric Radiology Pub Date : 2025-08-06 DOI:10.1007/s00247-025-06344-w

Samuel X Ramirez, Stuart D Ferrell, Indranil V Kushare, J Herman Kan

{"title":"Bipartite patella revisited: the not so asymptomatic accessory ossicle.","authors":"Samuel X Ramirez, Stuart D Ferrell, Indranil V Kushare, J Herman Kan","doi":"10.1007/s00247-025-06344-w","DOIUrl":null,"url":null,"abstract":"Background: The bipartite patella is a controversial variant, with definitions spanning from normal to stigmata related to patellofemoral dysplasia.Objective: The purpose of this study is to quantitatively determine if a bipartite patella is in the spectrum of normal versus forme fruste of underlying patellofemoral dysplasia in children using magnetic resonance imaging (MRI) data. A secondary purpose is to assess the MRI findings of the symptomatic bipartite and its implications for patient care.Materials and methods: A retrospective review of bipartite patellae imaged on knee MRI from 1/2010-3/2024 was conducted. Matched cohorts of control and patellofemoral dysplasia knees were created. Trochlear depth, sulcus angle, CDI, TT-TG, lateral patellar tilt and subluxation, lateral trochlear inclination, and clinical management were evaluated, comparing the bipartite knee MRIs with control and dysplastic knees. Chi-square and Mann-Whitney U tests were used, with P-values for significance set to 0.05.Results: From 46 patients, 47 bipartite patellae (mean age, 13.3 ± 3.1) were included in the study. In total, 77% (36/47) were male (mean age, 13.6 ± 3.0) while 23% (11/47) were female (mean age, 12.2 ± 3.2). No significant difference in quantitative measurements existed between bipartite patellae and control knees. Significant differences existed for all quantitative measurements defining trochlear dysplasia between bipartite and patellofemoral dysplasia cohorts (P<0.001 for all measurements). Bipartite ossicle edema (39/47, 83%) and Hoffa fat pad edema (17/47, 36%) were frequently present. Six of 47(13%) required surgery for pain management- all had ossicle edema present.Conclusion: The presence of a bipartite patella does not appear to be associated with underlying patellofemoral dysplasia. The bipartite patella can frequently be a source of a child's pain and should not be treated as a normal ossification variant.","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.3000,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pediatric Radiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00247-025-06344-w","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PEDIATRICS","Score":null,"Total":0}

引用次数: 0

Abstract

Background: The bipartite patella is a controversial variant, with definitions spanning from normal to stigmata related to patellofemoral dysplasia.

Objective: The purpose of this study is to quantitatively determine if a bipartite patella is in the spectrum of normal versus forme fruste of underlying patellofemoral dysplasia in children using magnetic resonance imaging (MRI) data. A secondary purpose is to assess the MRI findings of the symptomatic bipartite and its implications for patient care.

Materials and methods: A retrospective review of bipartite patellae imaged on knee MRI from 1/2010-3/2024 was conducted. Matched cohorts of control and patellofemoral dysplasia knees were created. Trochlear depth, sulcus angle, CDI, TT-TG, lateral patellar tilt and subluxation, lateral trochlear inclination, and clinical management were evaluated, comparing the bipartite knee MRIs with control and dysplastic knees. Chi-square and Mann-Whitney U tests were used, with P-values for significance set to 0.05.

Results: From 46 patients, 47 bipartite patellae (mean age, 13.3 ± 3.1) were included in the study. In total, 77% (36/47) were male (mean age, 13.6 ± 3.0) while 23% (11/47) were female (mean age, 12.2 ± 3.2). No significant difference in quantitative measurements existed between bipartite patellae and control knees. Significant differences existed for all quantitative measurements defining trochlear dysplasia between bipartite and patellofemoral dysplasia cohorts (P<0.001 for all measurements). Bipartite ossicle edema (39/47, 83%) and Hoffa fat pad edema (17/47, 36%) were frequently present. Six of 47(13%) required surgery for pain management- all had ossicle edema present.

Conclusion: The presence of a bipartite patella does not appear to be associated with underlying patellofemoral dysplasia. The bipartite patella can frequently be a source of a child's pain and should not be treated as a normal ossification variant.

查看原文本刊更多论文

髌骨二部复诊：不那么无症状的副听骨。

背景：双部髌骨是一种有争议的变异，其定义从正常到与髌骨股发育不良相关的柱头不等。目的：本研究的目的是利用磁共振成像（MRI）数据定量确定儿童髌骨发育不良的两部分髌骨是否在正常与形成的频谱中。第二个目的是评估症状性两部的MRI表现及其对患者护理的影响。材料与方法：回顾性分析2010年1月至2024年3月膝关节MRI双侧髌骨图像。建立了对照和髌骨发育不良膝关节的匹配队列。评估滑车深度、沟角、CDI、TT-TG、髌骨外侧倾斜和半脱位、滑车外侧倾斜和临床处理，并将双侧膝关节mri与正常膝关节和发育不良膝关节进行比较。采用卡方检验和Mann-Whitney U检验，p值为0.05。结果：纳入46例患者，共47例双侧髌骨，平均年龄13.3±3.1岁。男性占77%(36/47)，平均年龄13.6±3.0岁；女性占23%(11/47)，平均年龄12.2±3.2岁。双侧髌骨与对照膝的定量测量无显著差异。界定滑车发育不良的所有定量测量结果在两部分和髌骨发育不良组之间存在显著差异(结论：两部分髌骨的存在似乎与潜在的髌骨发育不良无关。两部分髌骨经常是儿童疼痛的来源，不应被视为正常的骨化变异。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Pediatric Radiology 医学-核医学

CiteScore

4.40

自引率

17.40%

发文量

300

审稿时长

3-6 weeks

期刊介绍： Official Journal of the European Society of Pediatric Radiology, the Society for Pediatric Radiology and the Asian and Oceanic Society for Pediatric Radiology Pediatric Radiology informs its readers of new findings and progress in all areas of pediatric imaging and in related fields. This is achieved by a blend of original papers, complemented by reviews that set out the present state of knowledge in a particular area of the specialty or summarize specific topics in which discussion has led to clear conclusions. Advances in technology, methodology, apparatus and auxiliary equipment are presented, and modifications of standard techniques are described. Manuscripts submitted for publication must contain a statement to the effect that all human studies have been reviewed by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in an appropriate version of the 1964 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted.