While cervical disc pathology can unquestionably produce radiculopathy, many patients presenting with arm pain, paresthesia or perceived weakness do not exhibit the clinical behavior of true nerve-root compromise. In these cases, failure to differentiate the primary pain generator may lead to unnecessary spinal injections, nerve ablation procedures or surgical consultation despite limited likelihood of benefit.
Journal of Manipulative Physicological Therapeutics
Double Patellae Syndrome with a Form of Multiple Epiphyseal Dysplasia
Terry R. Yochum, DC, Christie G. Sprowl, DC, and Michael S. Barry, DC
ABSTRACT
Objective: To present an interesting and unusual case of double patella syndrome in a patient with multiple epiphyseal dysplasia. The pertinent clinical and radiographic findings and a brief review of the literature are discussed.
Clinical Features: An 11-year-old male patient suffered from occasional right hip pain and limited range of motion, as well as a non-tender soft tissue mass in the right knee. Radiographic examinations of the hips and knees were performed and demonstrated bilateral double layered patellae and bilateral coxa magna deformity.
Interventions and Outcomes: Although surgery was initially recommended, conservative chiropractic management was employed and resulted in complete resolution of the patient's presenting hip syndrome.
Conclusion: This case is the first reported of double patellae seen on MRI and demonstrates the value of this technology in the noninvasive preoperative assessment of double patella syndrome. The patient's clinical and radiographic features led to the correct diagnosis.
Key Indexing Terms: Patella, Multiple Epiphyseal Dysplasia