Free
Clinical Images  |   December 2016
Bipartite Patella
Author Notes
  • From the Edward Via College of Osteopathic Medicine in Spartanburg, South Carolina (Student Doctor Jennings), and the Department of Emergency Medicine at Midlands Emergency Physicians Group at the Palmetto Tuomey Medical Center in Sumter, South Carolina (Dr Tjiattas-Saleski). 
  •  * Address correspondence to Lindsay Tjiattas-Saleski, DO, MBA, Palmetto Tuomey Medical Center, 129 N Washington St, Sumter, SC 29150-4949. E-mail: lrtj55@yahoo.com
     
Article Information
Imaging / Neuromusculoskeletal Disorders / Pediatrics / Clinical Images
Clinical Images   |   December 2016
Bipartite Patella
The Journal of the American Osteopathic Association, December 2016, Vol. 116, 816. doi:10.7556/jaoa.2016.158
The Journal of the American Osteopathic Association, December 2016, Vol. 116, 816. doi:10.7556/jaoa.2016.158

Keywords: bipartite patella, knee pain, patellar cartilage

A 28-year-old woman presented to the emergency department with left lateral knee pain after a motor vehicle crash. There was no indication of superficial trauma or deficit on physical examination. Plain radiographs of the left knee (image A and image B) showed patella fragments, which were determined to be secondary to congenital bipartite patella.1 The patient was treated conservatively with nonsteroidal anti-inflammatory drug therapy, and rest, ice, compression, and elevation were suggested. 
Bipartite patella is caused by a failure in ossification of the patellar cartilage at its secondary ossification center.2 Bipartite patella is usually asymptomatic, but symptoms can be exacerbated by physical activity secondary to microtrauma.3 Management is dependent on the degree of disability. Conservative management includes restriction of activity, nonsteroidal anti-inflammatory drug therapy, and corticosteroid joint injections for sustained pain relief.1,4 If conservative management fails or symptoms worsen, surgical intervention may be necessary. 
References
Gaheer RS, Kapoor S, Rysavy M. Contemporary management of symptomatic bipartite patella. Orthopedics. 2009;32(11). doi:10.3928/01477447-20090922-20
Price CT, Herrera-Soto J. Fractures of the patella. In: Beaty B, Kasser J, eds. Rockwood and Wilkins Fractures in Children. Philadelphia, PA: Lippincott Williams & Wilkins; 2010:877-880.
Westrom M, Parviainen M, Pihlajamaki HK. Excision of painful bipartite patella: good long-term outcome in young adults. Clin Orthop Rel Res. 2008;466(11):2848-2855. doi:10.1007/s11999-008-0367-4 [CrossRef]
Dundar U, Solak O, Cakir T. An [sic] usual painful bipartite patella. Eur J Gen Med. 2009;6(1):52-54.