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Review Question - QID 3281

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QID 3281 (Type "3281" in App Search)
A 27-year-old football player sustains an acute lateral patellar dislocation. Which of the following is the most likely site of injury seen on MRI?

Midsubstance oblique retinacular ligament rupture

10%

390/3965

Soft-tissue avulsion of medial patellofemoral ligament

58%

2310/3965

Midsubstance medial patellofemoral ligament rupture

21%

813/3965

Partial quadriceps tendon rupture

2%

84/3965

Bony avulsion of medial patellofemoral ligament

9%

345/3965

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The most common site of medial patellofemoral ligament (MPFL) injury is a soft-tissue avulsion injury of the ligament. Both midsubtance and soft tissue avulsions are more common than bony avulsions.

Bony avulsion off the patella can occur as well, and according to the referenced study by Torisuka et al, the MPFL remains attached to the medial patellar fragment and excellent clinical and radiographic results can occur with open reduction and fixation with suture anchors.

The reported study by Nomura et al reported that MRI is >80% sensitive and >80% specific (regarding location) for detecting MPFL injuries as well as their location. In addition, they noted a 96% MPFL injury rate with patellar dislocation.

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