Ultrasound Patella

FIGURE 7.3. Adipose tissue thickness in people in the general population (solid bars) and in obese persons (dashed bars). Adipose tissue thickness was measured by ultrasound measurements (not by the usual technique of skinfold measurements) at the gluteal site (G), femoral site (F), hypogastric site (H), and epigastric site (E). The epigastric site that was used was one-third the distance down from the tip of the sternum to the umbilicus. This site was somewhat thicker in men than in women. The femoral site was one-third the distance down from the anterior superior Uiac spine (wide part of the pelvis) to the patella (knee). This site was much thicker in women than in men. Biopsies were also taken at the indicated sites and examined imder the microscope to acquire fat cell size. (Redrawn with permission from Krotkiewski et ah, 1983.)... 

Sleeve avulsion fractures are a particular form of avulsion injury seen in the unossified skeleton which differs from avulsions in adults because the sleeve of periosteum which is pulled off can continue to form bone if not treated. The typical location is at the lower pole of the patella, but the upper pole of the patella, the olecranon and the medial epicondyle can also be affected. Ultrasound demonstrates a sleeve of cartilage that has been avulsed usually with a small fragment of bone (Hunt and Somashekar 2005). In some cases a double cortical sign may be present, indicating elevation of a superficial layer of cortex from the underlying bone. There maybe associated haemarthrosis and patella alta (Fig. 4.14). 

Fig. 4.14. Ultrasound demonstrating a patellar sleeve avulsion (arrowheads) from the inferior pole of the patella...

Hsu CC, Tsai WC, Chen CP, Yeh WL, Tang SF, Kuo JK (2005) Ultrasonographic examination of the normal and injured posterior cruciate ligament. J Clin Ultrasound 33 277-282 Hubner U, Schlicht W, Outzen S, Barthel M, Halsband H (2000) Ultrasound in the diagnosis of fractures in children. J Bone Joint Surg Br 82 1170-1173 Hunt DM, Somashekar N (2005) A review of sleeve fractures of the patella in children. Knee 12 3-7 Kannus P (2000) Structure of the tendon connective tissue. 

Ditchfield A, Sampson MA, Taylor GR (2000) ultrasound diagnosis of sleeve fracture of the patella. Clin Radiol 55 467-469... 

---