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The Prepatellar Bursa: Cadaveric Investigation of Regional Anatomy with MRI After Sonographically Guided Bursography

Rodrigo O. Aguiar1,2,3, Flavio C. Viegas1, Rodrigo Y. Fernandez1, Debra Trudell1, Parviz Haghighi4 and Donald Resnick1

1 Department of Radiology, Veterans Affairs Medical Center, University of California, San Diego, CA.
2 Present Address: Department of Radiology, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
3 Present Address: Av. Brasilia 5474, ap 83 bl B, Curitiba, Brazil 80240-240.
4 Department of Pathology, Veterans Affairs Medical Center, University of California, San Diego, CA.


Figure 1
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  		Fig. 1 —Diagram shows compartmentalization of prepatellar bursa. SCCT = subcutaneous cellular tissue; QT = quadriceps tendon; PT = patellar tendon; F = femur; 1 = superficial compartment, or prepatellar subcutaneous bursal space, between subcutaneous tissue and transverse superficial fascia; 2 = intermediate compartment, or prepatellar subfascial bursal space, situated between transverse superficial fascia and intermediate oblique fascia; 3 = deepest compartment, or prepatellar subaponeurotic bursal space, between intermediate oblique fascia and deep longitudinal fibers of rectus femoris tendon, which inserts directly in patella (P).

 

Figure 2
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  		Fig. 2 —Cadaver of 79-year-old woman. Lateral extension of prepatellar bursa. Fat-suppressed axial T1-weighted spin-echo MR image (TR/TE, 500/13) shows lateral margin (straight arrow) of patella (P) and lateral margin of prepatellar bursa (curved arrow). Septum compartmentalizing bursa is evident (arrowheads).

 

Figure 3
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  		Fig. 3A —Cadaver of 69-year-old man. Sagittal T1-weighted spin-echo MR image (TR/TE, 500/13) without fat suppression. Image shows patella (P), transverse superficial fascia (arrows), and intermediate oblique fascia (arrowheads).

 

Figure 4
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  		Fig. 3B —Cadaver of 69-year-old man. Sagittal T1-weighted spin-echo MR image (500/13) with fat suppression. Image shows patella (P), transverse superficial fascia (arrows), and intermediate oblique fascia (arrowheads).

 

Figure 5
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  		Fig. 3C —Cadaver of 69-year-old man. Anatomic photograph. Image shows patella (P), transverse superficial fascia (arrows), and intermediate oblique fascia (arrowheads).

 

Figure 6
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  		Fig. 3D —Cadaver of 69-year-old man. Photomicrograph shows transverse superficial fascia (arrows), intermediate oblique fascia (arrowheads), subcutaneous cellular tissue (SCCT), and rectus femoris tendon fibers (TF). (H and E, x10)

 

Figure 7
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  		Fig. 4A —Cadaver of 65-year-old woman. T1-weighted spin-echo MR image (TR/TE, 500/13) without fat suppression. Image shows tricompartmental patellar bursa in axial plane, patella (P), transverse superficial fascia (arrows), and intermediate oblique fascia (arrowheads).

 

Figure 8
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  		Fig. 4B —Cadaver of 65-year-old woman. T1-weighted spin-echo MR image (500/13) with fat suppression. Image shows tricompartmental patellar bursa in axial plane, patella (P), transverse superficial fascia (arrows), and intermediate oblique fascia (arrowheads).

 

Figure 9
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  		Fig. 4C —Cadaver of 65-year-old woman. Anatomic photograph shows two thin layers compartmentalizing prepatellar bursa. Image shows tricompartmental patellar bursa in axial plane, patella (P), transverse superficial fascia (arrows), and intermediate oblique fascia (arrowheads).

 

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