title: Successful conservative management of symptomatic bilateral dorsal patellar defects presenting with cartilage involvement and bone marrow edema: MRI findings.
abstract: The dorsal patellar defect is a relatively rare entity that involves the superolateral quadrant of the patella. It is usually considered to represent a delayed ossification process, although its exact origin remains unclear. Because of its usually innocuous nature and clinical course, invasive interventions are generally deemed unnecessary, although curretage has been successfully performed on symptomatic cases. This case report presents a rather unusual case of symptomatic bilateral dorsal patellar defects with cartilage involvement and widespread surrounding bone marrow edema as demonstrated by magnetic resonance imaging (MRI). Both cartilage involvement and bone marrow edema should be considered part of the spectrum of associated MRI findings that can be encountered in this entity. Furthermore, the presented case shows that symptomatic dorsal patellar defects can be treated conservatively with success and that (decrease of) pain symptoms are likely related to (decrease of) bone marrow edema.
authors.affiliation: Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands. thomaskwee@gmail.com.|Department of Radiology, Meander Medical Center, Amersfoort, The Netherlands. thomaskwee@gmail.com.
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Kwee
authors.affiliation: Department of Orthopaedics, Meander Medical Center, Amersfoort, The Netherlands.
authors.forename: Heleen
authors.initials: H
authors.lastname: Sonneveld
authors.affiliation: Department of Radiology, Meander Medical Center, Amersfoort, The Netherlands.
authors.forename: Maarten
authors.initials: M
authors.lastname: Nix
mesh_terms: D000293:Adolescent; D001855:Bone Marrow Diseases / Q000000981:diagnostic imaging* / Q000628:therapy*; D002358:Cartilage, Articular / Q000000981:diagnostic imaging* / Q000473:pathology; D000072700:Conservative Treatment / Q000379:methods; D004487:Edema / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D010329:Patella / Q000000981:diagnostic imaging*; D016896:Treatment Outcome
keywords: Bilateral; Cartilage; Dorsal patellar defect; Edema; MRI; X-ray
references.citation: Eur Radiol. 2001;11(7):1136-9
references.pmid: 11471600
references.citation: Skeletal Radiol. 2010 Dec;39(12):1175-86
references.pmid: 20221595
references.citation: Clin Orthop Relat Res. 1979 Sep;(143):131-2
references.pmid: 509814
references.citation: AJR Am J Roentgenol. 1982 Aug;139(2):339-40
references.pmid: 6979889
references.citation: Skeletal Radiol. 1984;11(4):246-57
references.pmid: 6729496
references.citation: Am J Sports Med. 1986 Sep-Oct;14(5):425-7
references.pmid: 3777323
references.citation: Skeletal Radiol. 1987;16(4):304-11
references.pmid: 3112959
references.citation: Arthroscopy. 1993;9(2):164-9
references.pmid: 8461074
references.citation: Skeletal Radiol. 1993 Oct;22(7):528-31
references.pmid: 8272891
references.citation: Radiology. 1995 Jun;195(3):849-53
references.pmid: 7754020
references.citation: Korean J Radiol. 2004 Oct-Dec;5(4):274-9
references.pmid: 15637478
references.citation: Clin Genet. 2005 Oct;68(4):302-19
references.pmid: 16143015
references.citation: Eur Radiol. 2003 Dec;13 Suppl 6:L164-77
references.pmid: 16440220
references.citation: Eur Radiol. 2009 Mar;19(3):701-12
references.pmid: 18815789
references.citation: Radiology. 1979 Feb;130(2):333-6
references.pmid: 760144