Dorsal Defect of the Patella (DDP): A Characteristic Radiographic Lesion

Goergen, Thomas G.; Resnick, Donald; Greenway, Guerdon; Saltzstein, Sidney L.

doi:10.1148/130.2.333

Cited by 35 publications

(35 citation statements)

References 8 publications

(2 reference statements)

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“…It has been stated that the radiographic characteristics of DDP are specific enough that no further evaluation is necessary [1]. In our case, the typical lytic lesion surrounded by sclerosis was located in the superior lateral aspect of the patella and positive on bone scan.…”

Section: Discussionmentioning

confidence: 54%

“…Microscopic exam reveals viable spicules of bone separated by fibrous tissue. Lymphocytes are found but not giant cells [1].…”

Section: Discussionmentioning

confidence: 92%

“…Since DDP always occurs in the same area as a bipartite patella, it may represent a delay in normal ossification. This belief is supported by the fact that most cases of DDP will spontaneously regress (ossify) [1].…”

Section: Discussionmentioning

confidence: 96%

“…Review of the literature reveals a diverse variety of bony lesions of the patella, including dorsal defect of the patella (DDP) [1][2][3][4], chondroblastoma, osteoblastoma, aneurysmal bone cyst, osteoid osteoma, lymphoma, hemangioma, cystic tuberculosis, osteomyelitis, osteogenic sarcoma, metastatic lesions, intraosseous ganglion cyst, unicameral bone cyst, eosinophilic granuloma, osteochrondritis dissecans, giant cell tumor, and one case of Brodie's abcess [5].…”

Section: Discussionmentioning

confidence: 99%

“…Radiographicall3; DDP presents as a rounded, well defined, lucent lesion with sclerotic borders, always located along the superior lateral border of the patella, adjacent to the articular cartilage [4]. DDP may show increased activity on bone scan, especially in symptomatic patients [1,2].…”

Section: Discussionmentioning

confidence: 99%

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Dorsal defect of the patella and infection

1987

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Abstract. Lesions of the patella are relatively rare, although a large variety of etiologies have been reported. To our knowledge this is only the second reported case of a Brodie's abcess of the patella. Its radiologic appearance was identical to that described for the common dorsal defect of the patella. Case reportThis 13-year-old white female initially presented with bilateral knee pain, associated with regular athletics. After a regimen of quadriceps conditioning exercises, she returned to competitive basketball.One month later she developed a spontaneous left knee effusion. The knee examination revealed a moderate effusion with patello-femoral crepitus, no erythema or warmth and a full range of motion.Plain films (Figs. 1, 2) of the knee revealed a well defined, rounded, one centimeter lyric lesion in the upper lateral aspect of the patella. The lesion had a sclerotic border and abutted the dorsal articular surface of the patella. The triple phase bone scan showed increased activity in the flow, blood pool, and delayed images (Fig. 3). The remainder of the skeleton was normal. The sedimentation rate and white blood cell count were normal.Since symptoms did not resolve over several weeks, the family requested diagnostic surgery. A large suprapatellar plica was arthroscopically lysed but no other intra-articular abnormalities were seen. An open biopsy revealed a cystic cavity. Serous contents were cultured and the soft tissue lining membrane curetted to viable bone. The arthroscopic synovial biopsy showed chronic inflammation but cultures of the cyst remained negative. Her symptoms completely resolved after three weeks of empirical anti-staphylococcal antibiotics.

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Section: Discussionmentioning

confidence: 54%

“…Microscopic exam reveals viable spicules of bone separated by fibrous tissue. Lymphocytes are found but not giant cells [1].…”

Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 96%