Distinguish from patella (4)
I believe the answer is:
tell
'distinguish' is the definition.
('tell' can be a synonym of 'distinguish')
'from patella' is the wordplay.
'from' indicates a hidden word.
'TELL' can be found hidden inside 'patella'.
(Other definitions for tell that I've seen before include "toxophilite" , "Instruct" , "One who refused to accept tyranny" , "his hitting the apple?" , "work in a bank" .)