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Patellar Contusion

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Other Names

  • Patella contusion
  • Patellar bruise

Background

History

Epidemiology

  • Common in pediatrics
  • One study estimated 29.1% of knee injuries seen in the ED were "knee contusions" in the pediatric population[1]
    • Note that "knee contusion" included all comers, not specifically patella
    • It was more common in males (31.8%) than females (22.8%)
  • Moustaki found 43.5% of kids with knee injury were diagnosed with "knee contusion"[2]
    • The most common etiology was fall or direct impact while playing at home or the playground

Pathophysiology

  • General
    • Bone bruises/ contusions should be thought of as radiographically occult bone injuries
  • Etiology
    • Direct blunt trauma to the patella during sport
    • Common culprits include minor falls during play or sport

Associated Conditions


Risk Factors

  • Unknown

Differential Diagnosis


Clinical Features

  • History
    • Patients should be able to describe the trauma
    • Primarily complain of pain, swelling
  • Physical Exam: Physical Exam Knee
    • Erythema, prepatellar swelling may be present
    • Tenderness along point of contact
    • Fluctuance suggest prepatellar bursitis
    • Extensor mechanism should be intact despite pain
    • Range of motion is intact, effusion typically absent
  • Special Tests

Evaluation

Radiology

MRI

  • Not typically indicated

Ultrasound

  • Not typically indicated
  • May be used in lieu of radiographs to evaluate patella and extensor mechanism

Classification

  • Not applicable

Management

Nonoperative

Operative

  • There are no surgical indications for this injury

Rehab and Return to Play

Rehabilitation

  • No specific rehabilitation program exists

Return to Play/ Work

  • Most patients will have symptom resolution in 1-3 weeks
    • Can return to play along that timeline

Complications and Prognosis

  • Patellar contusion is a self limiting injury
    • Expect full return to play after symptoms resolve

See Also


References

  1. Gage, Brett E., et al. "Epidemiology of 6.6 million knee injuries presenting to United States emergency departments from 1999 through 2008." Academic emergency medicine 19.4 (2012): 378-385.
  2. Moustaki, M., et al. "Home and leisure activities and childhood knee injuries." Injury 36.5 (2005): 644-650.
Created by:
John Kiel on 8 July 2021 13:45:48
Authors:
Last edited:
4 October 2022 15:56:42
Categories:
Knee | Lower Extremity | Trauma | Pediatrics | Acute