Optimizing patellar imaging: What every radiologist should know

The patella, biggest of all sesamoid bones, is an integral part of knee biomechanical function. It is a pivot for the quadriceps, enabling them to stabilize and contract during motion. With its complex shape, comprising many stabilizing structures and significant parts of articulation, its evaluation and analysis become a challenging issue in radiology departments worldwide. In this article, its evaluation with conventional radiography and Multidetector Computed Tomography, and its role in patellar pathology, have been discussed. In an extended discussion, key measurements, such as the trochlear groove angle, Merchant's congruence angle, and TT-TG distance, in diagnosing trochlear dysplasia, lateral patellar dislocation, and patellofemoral instability, have been discussed in detail. Certain radiological report-enhancing techniques and standardization have been discussed, providing a pragmatic view for maximizing such a pathology's diagnosis and management. The intention of this article is not to prescribe definite methodologies but to introduce tools for a correct patellar pathology and its implications in a reliable manner.