Inferior patellar pole fragmentation in children: just a normal variant?

Abstract:

BACKGROUND:Fragmentary ossification of the inferior patella is often dismissed as a normal variant in children younger than 10 years of age. OBJECTIVE:The purpose of this study was to determine whether fragmentary inferior patellar pole ossification is a normal variant or is associated with symptoms or signs of pathology using MRI and clinical exam findings as reference. MATERIALS AND METHODS:A retrospective review was performed on 150 patients ages 5-10 years who underwent 164 knee radiography and MRI exams (45.1% male, mean age: 7.8 years). The presence or absence of inferior patellar pole fragmentation on radiography was correlated with the presence or absence of edema-like signal on MR images. Clinical notes were reviewed for the presence of symptoms or signs referable to the inferior patellar pole. These data were compared with a 1:1 age- and sex-matched control group without inferior pole fragmentation. Statistical analysis was performed using two-tailed t-tests. RESULTS:Forty of 164 (24.4%) knee radiographs showed fragmentary ossification of the inferior patella. Of these 40 knees, 62.5% (25/40) had edema-like signal of the inferior patellar bone marrow compared with 7.5% (3/40) of controls (P = 0.035). Patients with fragmentary ossification at the inferior patella had a significantly higher incidence of documented focal inferior patellar pain compared with controls (20% vs. 2.5%, P = 0.015). CONCLUSION:Inferior patellar pole fragmentation in children 5 to 10 years of age may be associated with localized symptoms and bone marrow edema-like signal and should not be routinely dismissed as a normal variant of ossification.

journal_name

Pediatr Radiol

journal_title

Pediatric radiology

authors

Kan JH,Vogelius ES,Orth RC,Guillerman RP,Jadhav SP

doi

10.1007/s00247-014-3240-5

subject

Has Abstract

pub_date

2015-06-01 00:00:00

pages

882-7

issue

6

eissn

0301-0449

issn

1432-1998

journal_volume

45

pub_type

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