PurposeBipartite patella is a rare developmental variation of the knee cap. We aimed to identify the magnetic resonance imaging (MRI) features of bipartite patella and evaluate the association with clinical symptoms.Material and methodsMRI exams of 61 patients with bipartite variant were evaluated for types of bipartite patella, oedema around the synchondrosis, bipartite fragment height (FH), distance between the fragment and the patella (FPD), and signal characteristics within the synchondrosis. The study was designed with two observers in order to achieve intra- and interobserver compliance. Any other major knee pathologies that can cause pain were also recorded.ResultsOf the 61 participants the average age was 40.1 ± 14.3 years, 44 were males, and 17 were females. Fifty-nine of the bipartite fragments were located at the superolateral quadrant of the patella. There was oedema at the bipartite area in 35 patients. Ten of these patients had no major MRI diagnosis other than oedema, and they were classified as the symptomatic group. The age of the patients in the symptomatic group was statistically lower than in the asymptomatic group (p < 0.05). There was no statistically significant difference between the groups in terms of male and female distributions, signal types across the synchondrosis, and FH or FPD measurements (p > 0.05). High concordance correlation coefficients were observed on measurementsConclusionsMRI of the knee is highly accurate in evaluation of bipartite patella. To our knowledge; a detailed MRI analysis, like in our study, has not previously been performed, and our report is unique in showing that the symptomatic occurrence of bipartite patella is statistically higher in young patients.
Rebleeding of cerebral aneurysms has been previously reported during diagnostic angiography. However, capturing the exact moment of active rebleeding of a cerebral aneurysm during angiography is extremely rare. Here, a case of a rebleeding middle cerebral artery aneurysm during diagnostic digital subtraction angiography (DSA) was illustrated, accompanied with a video demonstration of the incident which is the only one in the literature. During the acquisition of lateral projection DSA images, active extravasation of the contrast medium was witnessed, indicating rebleeding. Simultaneously, there was a sudden rise in arterial blood pressure and an episode of bradycardia. The procedure was terminated immediately and the patient was transferred to the intensive care unit for extraventricular drainage and stabilization of vital signs. Unfortunately, the patient was lost.
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