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Effectiveness of X‐ray in Detecting the Fabella Sesamoid Bone

The highly variable prevalence of the fabella, a sesamoid bone located posterior to the lateral condyle of the femur, invites further investigation. A recent meta‐analysis by Berthaume [J. Anat. 2019 Jul; 235(1): 67‐79. doi:10.1111/joa.12994] reports that the incidence rate of the fabella has increased over the past 150 years. Within the data aggregated by that study, there is also a significant difference in detecting the fabella based on the method of detection ‐ anatomical dissection (28.9% prevalence, N = 5723 knees) vs. X‐ray (15.3% prevalence, N = 13665 knees). We sought to investigate whether variation in the density of fabellae could explain both changes in its prevalence over time as well as the discrepancy between methodologies.