Bilateral Osteochondrosis of the Primary Patellar Ossification Centers in a Young Athlete

A Case Report

Aisha S. Dharamsi, MD; Rebecca L. Carl, MD


Clin J Sport Med. 2014;24(1):80-82. 

In This Article

Abstract and Introduction


Osteochondroses are a group of idiopathic self-limited conditions seen in skeletally immature individuals. The term describes disturbances in endochondral ossification affecting either the primary or secondary ossification centers. Osteochondrosis of the tarsal navicular was first described by Köhler in 1908; the eponym "Köhler's disease" is commonly used to refer to this condition. In his original paper, Köhler also described one instance of an osteochondrosis of the primary patellar ossification center, a clinical entity that has since rarely been reported. We present a case of isolated bilateral "Köhler's disease of the patellae" in an approximately 7-year-old male athlete demonstrated clinically and radiographically by both plain radiographs and magnetic resonance imaging.


Osteochondroses are a heterogeneous group of conditions unique to the skeletally immature population.[1] They occur secondary to disturbances in endochondral ossification. Osteochondroses are idiopathic, self-limited,[2] and radiographically characterized by fragmentation and sclerosis of the involved bone.[3]

In 1908, Köhler first described osteochondrosis of the tarsal navicular in 3 patients,[4] a condition now commonly referred to as "Köhler's disease" of the tarsal scaphoid. In 1 case, he also noted osteochondrosis of the primary patellar ossification center,[4] a condition rarely reported in the literature.[2,3,5–8] To our knowledge, this is the first case of isolated bilateral osteochondrosis of the primary patellar ossification centers identified radiographically by both x-ray and magnetic resonance imaging (MRI).