Two types of patellar stress fractures occur: longitudinal and transverse [69]. It has also been suggested that in some cases a chronic symptomatic bipartite patella could represent a chronic patellar stress fracture [70]. An exceptionally rare case of a running related transverse patellar stress fracture in a 12-year-old misdiagnosed for 5 months as Sinding-Larsen-Johansson disease has been reported [71]. These cases illustrate the need to consider stress injuries, even when the patient's signs and symptoms are more typical for an alternative diagnosis. Considering this diagnosis early on may result in an early diagnosis, which may significantly alter the course of the injury and shorten the recovery time. Imaging findings of patellar stress injuries will typically parallel findings in other locations.

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