Physical Address
304 North Cardinal St.
Dorchester Center, MA 02124
A 14-year-old female is brought to the Emergency Department following a basketball game. She pivoted to take a shot and felt a tearing sensation, followed by a pop, then fell to the ground. She presents with an obvious right knee deformity. Her vital signs are normal for her age, and on examination, her knee is held in flexion at 30 degrees with a laterally palpable patella. She is grossly neurovascularly intact and there are no other injuries. Interestingly, the patient tells you she had the same injury twice in the past, most recently 5 months ago, involving the left knee, but never on the right. She is otherwise healthy.
Imaging is often employed in the evaluation of children with orthopedic complaints. Generally, imaging begins with plain radiography and progresses to other modalities based on history and physical examination. In the case of patellar dislocation, imaging may not be necessary prior to reduction unless there is concern for alternate diagnosis, as dislocation is often clinically apparent. Postreduction imaging is advised to evaluate for an osteochondral fracture, which is considered an indication for operative management ,
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