12-year-old male with anterior knee pain

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Left knee pain.

Long- and short-axis fat- and water-weighted images were performed. 

  • An inflamed ununited inferior patellar tubercle apophysis is present with ununited apophysis favored over inferior tubercle with fracture and secondary necrosis on a chronic longstanding basis. 
  • Nevertheless similar symptomatology would result producing a clinical syndrome namely that of jumper’s knee. The entire surrounding area including the adjacent patellar tendon is swollen but not torn or ruptured. 
  • Infra- and retropatellar induration suggests patellofemoral maltracking. 
  • In the lateral aspect of the medial femoral condyle is a remote subcortical and subchondral scar consistent with healed old small focus of osteochondritis dissecans. 
  • The menisci are intact. The cruciates are intact. The collaterals are intact.

Sinding-Larsen-Johansson syndrome or ununited dysplastic inferior patellar tubercle with remote fracture and necrosis or fragment a much less likely consideration but either resulting in marked infrapatellar inflammation and the clinical syndrome of jumper’s knee. Secondary hoffitis.

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