An 18-Year-Old Female Athlete Presenting with Knee Pain Following a Basketball Game and Diagnosed with Bilateral Patellar Stress Fractures

Patient: Female, 18-year-old Final Diagnosis: Bilateral patellar stress fractures Symptoms: Bilateral anterior knee pain Clinical Procedure: Open reduction internal fixation of the patella Specialty: Orthopedics and Traumatology • Sports Medicine OBJECTIVE: Rare disease BACKGROUND: Stress fractures of the patella are rare, may result from overuse, and can be difficult to detect on imaging. Furthermore, the differential diagnosis of the anterior knee pain associated with most patellar stress fractures is broad, making it difficult to quickly reach the diagnosis. This report is of an 18-year-old female athlete presenting with knee pain after playing basketball and diagnosed with bilateral patellar stress fractures. CASE REPORT: An 18-year-old female athlete with a history of bilateral anterior knee pain presented with left knee pain and swelling following a basketball game. X-ray images and magnetic resonance imaging (MRI) revealed a displaced inferior pole fracture of the left patella. The patient underwent surgical fixation of the patella. Approximately 4 months following surgical fixation of the left patella, right anterior knee pain persisted, and imaging demonstrated a stress reaction in the inferior pole of the right patella. The patient was ultimately treated with surgical fixation of the right patella as well. CONCLUSIONS: This report demonstrates that, although stress fractures of the patella are rare, and bilateral stress fractures of the patella are even more rare, this condition may present with pain and usually with a history of high-impact exercise. Challenges remain in identifying patellar stress fractures early in their progression and determining the best course of treatment.