Idiopathic osteonecrosis of the patella: an unusual cause of pain in the knee. A case report.
نویسندگان
چکیده
Case Report A sixteen-year-old white girl had a history of pain in the right knee for four months, especially in the medial joint line, and occasional episodes of giving-way during sports activities. She could recall no trauma to the knee. Examination of the knee was unremarkable except for slight tenderness over the medial joint line. There was no effusion, and the McMurray and Lachman tests were normal. Radiographs showed a poorly defined ovoid defect with a sclerotic margin in the superolateral part of the right patella; this was apparently asymptomatic and was thought to be benign. Radiographs of the left knee were normal. An arthrogram showed a probable tear of the medial meniscus of the right knee. Two months later, arthroscopy revealed a small parrot-beak tear of the lateral meniscus and a normal medial meniscus. The articular cartilage, including that of the patella, appeared to be entirely normal. The torn part of the meniscus was shaved to form a smooth rim. Two months after arthroscopy, the patient began to complain of new pain over the superolateral aspect of the patella of the right knee. The pain occasionally radiated around the entire knee and frequently awakened her at night. She had no fever or chills. On physical examination, the pain was reproducible on palpation of the superolateral part of the patella. There was no effusion or increased warmth of the knee. The knee had a full range of motion, with mild pain
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ورودعنوان ژورنال:
- The Journal of bone and joint surgery. American volume
دوره 73 10 شماره
صفحات -
تاریخ انتشار 1990