Imaging Quiz: Closed Reduction of an Everted Patella
Richard B. Ganong, MDTHE PHYSICIAN AND SPORTSMEDICINE - VOL 24 - NO. 2 - FEBRUARY 96
A 29-year-old woman was struck from behind while skiing, sustaining a blow to her back that threw her into the air, at which time she heard a "pop" in her left knee before hitting the ground. She arrived at the base facility clinic in acute distress with the ski patrol report of a kneecap dislocation.
At first glance, the patella was indeed dislocated laterally, but the knee was in the unusual position of full extension with the patella positioned vertically in the anteroposterior plane. The patellar tendon was unusually prominent and taut. Any attempt to manipulate the extremity was met with painfully tight resistance. Radiographs (figure 1) revealed a laterally displaced patella with the patellar facets facing laterally.
Given this unusual presentation, what is the next step in treatment?
Dr Ganong is an internist with the Truckee Tahoe Medical Group in Tahoe City, California. He is a fellow of the American College of Physicians. Address correspondence to Richard B. Ganong, MD, Box 2649, Olympic Valley, CA 96146.