Diagnosis: The conclusion reached by the orthopedist who initially saw this case was bipartate patella. However, the radiologist suspected a fracture.
The orthopedist reasoned that (a) the pain was not over the patella and (b) comparison with old films (which the radiologist did not have access to) showed no change.
The teaching point: Gather all available clinical information and old films whenever possible. Without this information, neither the orthopedist nor the radiologist could give an absolute final diagnosis. Interestingly, both the orthopedist and the radiologist noted that the patient should have a CT to confirm the status of the patella.
This case was managed by Dr. Rafold Livshin and Uri Frankl, and the x-rays reviewed by Dr. Scott Fields.
[taq_review]