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Ahead of Print
CASE REPORTS
Published online: 2020-08-07
Submitted: 2020-05-06
Accepted: 2020-07-28
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Bilateral double-layered patella in a patient with advanced knee osteoarthritis

P. Przybylski, M. Skoczyński, P. Tarkowski, M. Tarczyńska, K. Gawęda, A. Drop
DOI: 10.5603/FM.a2020.0089
·
Pubmed: 32789844

open access

Ahead of Print
CASE REPORTS
Published online: 2020-08-07
Submitted: 2020-05-06
Accepted: 2020-07-28

Abstract

Double layered patella (DLP) is a rare anomaly of the patella that may go undiagnosed, especially in patients with progressive knee dysfunction and early degenerative changes. Clinical symptoms such as motion-dependent pain and anterior knee pain most typically occur in adolescents or young adults, however, gradually increasing pain and early generalized degenerative changes have also been seen in patients over 40 years old.
Diagnosis of DLP could be difficult, especially in cases with coexisting arthrosis. DLP is considered to be pathognomonic for the diagnosis of multiple epiphyseal dysplasia (MED) and usually coexists with other anomalies seen in this syndrome, such as hip dysplasia. In extremely rare cases, DLP can occur as a solitary disorder. The prevalence of such cases, however, is unknown, and they could be easily misdiagnosed. Computed tomography (CT) and magnetic resonance imaging (MRI) are the most sensitive radiological methods used in DLP diagnosis. This case report presents a case of a bilateral DLP incidentally found in a 47-year old patient with advanced arthritis referred for arthroplasty because of increasing symptoms of knee joint failure with no other abnormalities recorded. An important goal of our case study is to raise the awareness of this abnormality with radiologists and orthopedic surgeons.

Abstract

Double layered patella (DLP) is a rare anomaly of the patella that may go undiagnosed, especially in patients with progressive knee dysfunction and early degenerative changes. Clinical symptoms such as motion-dependent pain and anterior knee pain most typically occur in adolescents or young adults, however, gradually increasing pain and early generalized degenerative changes have also been seen in patients over 40 years old.
Diagnosis of DLP could be difficult, especially in cases with coexisting arthrosis. DLP is considered to be pathognomonic for the diagnosis of multiple epiphyseal dysplasia (MED) and usually coexists with other anomalies seen in this syndrome, such as hip dysplasia. In extremely rare cases, DLP can occur as a solitary disorder. The prevalence of such cases, however, is unknown, and they could be easily misdiagnosed. Computed tomography (CT) and magnetic resonance imaging (MRI) are the most sensitive radiological methods used in DLP diagnosis. This case report presents a case of a bilateral DLP incidentally found in a 47-year old patient with advanced arthritis referred for arthroplasty because of increasing symptoms of knee joint failure with no other abnormalities recorded. An important goal of our case study is to raise the awareness of this abnormality with radiologists and orthopedic surgeons.

Get Citation

Keywords

bilateral double-layered patella, osteoarthritis

About this article
Title

Bilateral double-layered patella in a patient with advanced knee osteoarthritis

Journal

Folia Morphologica

Issue

Ahead of Print

Published online

2020-08-07

DOI

10.5603/FM.a2020.0089

Pubmed

32789844

Keywords

bilateral double-layered patella
osteoarthritis

Authors

P. Przybylski
M. Skoczyński
P. Tarkowski
M. Tarczyńska
K. Gawęda
A. Drop

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