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[MRI after patellar dislocation: assessment of risk factors and injury to the joint].
[trochlear dysplasia]
Patellar
dislocation
is
the
lateral
displacement
of
the
patella
from
the
femoral
trochlea
.
Affected
individuals
typically
have
underlying
anatomic
risk
factors
of
variable
magnitude
,
which
,
in
conjunction
with
leg
rotation
,
cause
the
event
.
Magnetic
resonance
imaging
(
MRI
)
permits
straightforward
diagnosis
of
the
typical
features
of
recent
patellar
dislocation
:
contusion
edema
of
the
inferomedial
patella
and
the
lateral
femoral
condyle
as
well
as
rupture
of
the
medial
patellofemoral
ligament
.
In
case
of
concomitant
osteochondral
injury
,
early
surgical
refixation
may
be
indicated
,
depending
on
the
size
.
After
a
first
dislocation
,
which
can
damage
the
capsuloligamentous
stabilizers
,
subjects
may
sustain
further
dislocations
or
even
develop
chronic
patellofemoral
instability
,
depending
on
the
presence
and
severity
of
anatomic
variants
.
A
wide
range
of
conservative
and
surgical
treatments
are
available
.
While
a
first
patellar
dislocation
is
often
treated
conservatively
,
surgical
strategies
after
a
second
dislocation
depend
on
the
pattern
of
injury
and
the
severity
of
underlying
anatomic
risk
factors
.
The
most
relevant
predisposing
variants
are
trochlear
dysplasia
,
patella
alta
,
and
an
abnormal
tibial
tubercle
to
trochlear
groove
distance
(
TT-
TG
)
.
The
radiologist
's
report
should
give
a
quantitative
estimate
of
both
the
injuries
resulting
from
dislocation
and
the
underlying
anatomic
risk
factors
.
An
accurate
characterization
of
the
individual
pathomechanism
is
crucial
for
tailoring
treatment
.
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