0:00

Okay,

0:01

the history on this one is 28-year-old

0:04

with anterior knee pain.

0:06

Query, meniscus tear.

0:08

Okay, stay with the same theme.

0:10

Axial.

0:13

Patellar shape, pretty good.

0:16

Trochlear groove, pretty good.

0:18

Lateral ridge, pretty good.

0:19

Medial ridge, pretty good.

0:20

Medial peripatellar plica, present.

0:22

Not uncommon.

0:23

That's normal.

0:24

Medial retinaculum, superficial.

0:27

And Medial Patellofemoral ligament,

0:29

a little bit laminated,

0:30

a little bit thickened,

0:32

but still present.

0:33

Lateral retinaculum, present.

0:35

Popliteal fossa, normal.

0:38

MCL, visible.

0:41

Popliteus tendon and the popliteus hiatus, visible.

0:44

And here's your fibular collateral ligament,

0:46

which will combine with the biceps

0:48

to form the conjoint.

0:50

There is your oblique popliteal ligament,

0:54

which forms the capsule in the midline

0:55

and connects to the other side.

0:58

Let's look at our sagittal now,

1:00

keeping with our same theme,

1:02

axial to sagittal,

1:04

we go to the sagittal.

1:06

Menisci, normal.

1:08

Anterior cruciate, normal.

1:10

Posterior cruciate, normal.

1:12

A little bit of induration of

1:15

the retropatellar space.

1:16

Very common in young individuals due to maltracking.

1:19

And the major finding,

1:21

look for the swelling is here.

1:23

This case is all about what's going

1:26

on on the front end.

1:27

This patient has delamination of the prepatellar plate,

1:32

which is the contiguation or continuation of

1:36

the rectus femoris fibers of the quadriceps

1:40

over the top of the patella.

1:43

Much like you have the

1:44

rectus abdominis fibers continuing over

1:47

the top of the synthesis pubis.

1:50

But these fibers have detached.

1:53

This is actually a four or five layered structure

1:57

with at least three and sometimes four bristle

1:59

layers, which we don't often think about.

2:02

This patient has delaminated the prepatellar plate.

2:05

The treatment is conservative.

2:07

This is probably something

2:08

you haven't seen before.

2:09

It's important to comment on the status

2:11

of the quadriceps, normal.

2:13

The status of the patellar tendon, normal.