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Parkar AP, Adriaensen MEAPM. ESR essentials: MRI of the knee-practice recommendations by ESSR. Eur Radiol 2024; 34:6590-6599. [PMID: 38536461 PMCID: PMC11399221 DOI: 10.1007/s00330-024-10706-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 02/05/2024] [Accepted: 02/07/2024] [Indexed: 05/07/2024]
Abstract
Many studies and systematic reviews have been published about MRI of the knee and its structures, discussing detailed anatomy, imaging findings, and correlations between imaging and clinical findings. This paper includes evidence-based recommendations for a general radiologist regarding choice of imaging sequences and reporting basic MRI examinations of the knee. We recommend using clinicians' terminology when it is applicable to the imaging findings, for example, when reporting meniscal, ligament and tendon, or cartilage pathology. The intent is to standardise reporting language and to make reports less equivocal. The aim of the paper is to improve the usefulness of the MRI report by understanding the strengths and limitations of the MRI exam with regard to clinical correlation. We hope the implementation of these recommendations into radiological practice will increase diagnostic accuracy and consistency by avoiding pitfalls and reducing overcalling of pathology on MRI of the knee. CLINICAL RELEVANCE STATEMENT: The recommendations presented here are meant to aid general radiologists in planning and assessing studies to evaluate acute and chronic knee findings by advocating the use of unequivocal terminology and discussing the strengths and limitations of MRI examination of the knee. KEY POINTS: • On MRI, the knee should be examined and assessed in three orthogonal imaging planes. • The basic general protocol must yield T2-weighted fluid-sensitive and T1-weighted images. • The radiological assessment should include evaluation of ligamentous structures, cartilage, bony structures and bone marrow, soft tissues, bursae, alignment, and incidental findings.
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Affiliation(s)
- Anagha P Parkar
- Radiology Department, Haraldsplass Deaconess Hospital, Postboks 6165 Posterminalen, 5892, Bergen, Norway.
- Department of Clinical Medicine, Faculty of Medicine and Dentistry, University of Bergen, Postboks 7804, 5021, Bergen, Norway.
| | - Miraude E A P M Adriaensen
- Department of Radiology, Zuyderland Medical Center, Henri Dunantstraat 5, 6419 PC, Heerlen, the Netherlands
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Schuldes S, Hackenbroch C. [Radiological diagnostics of patellofemoral instability and patellar dislocation]. RADIOLOGIE (HEIDELBERG, GERMANY) 2024; 64:278-286. [PMID: 38483571 DOI: 10.1007/s00117-024-01284-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/20/2024] [Indexed: 03/28/2024]
Abstract
Patellofemoral instability (PFI) describes a (sub)luxation of the patella in the patellofemoral joint. Pathophysiologically, PFI is usually due to a nonphysiological movement of the patella, so-called maltracking, either due to acute trauma with injury to the supporting ligamentous apparatus or due to the presence of anatomical risk factors. Radiologically assessable risk factors for maltracking include trochlear dysplasia, patella alta, patellar tilt, lateralization of the tibial tuberosity, torsional deformity and genu valgum. This article presents the most commonly used and best validated measurement techniques. In addition, the characteristic injury pattern after lateral patellar dislocation is shown.
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Affiliation(s)
- Sonja Schuldes
- Klinik für diagnostische und interventionelle Radiologie und Neuroradioradiologie, Bundeswehrkrankenhaus Ulm, Oberer Eselsberg 40, 89081, Ulm, Deutschland.
| | - Carsten Hackenbroch
- Klinik für diagnostische und interventionelle Radiologie und Neuroradioradiologie, Bundeswehrkrankenhaus Ulm, Oberer Eselsberg 40, 89081, Ulm, Deutschland
- Klinik für diagnostische und interventionelle Radiologie, Uniklinik Ulm, Ulm, Deutschland
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Lyu L, Li Y, Zhong J, Yao W. Association among peripatellar fat pad edema and related patellofemoral maltracking parameters: a case-control magnetic resonance imaging study. BMC Musculoskelet Disord 2023; 24:678. [PMID: 37626375 PMCID: PMC10463576 DOI: 10.1186/s12891-023-06827-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 08/23/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND The peripatellar fat pads are critical for protective cushioning during movement, and their endocrine function has been shown to affect osteoarthritis. Magnetic resonance imaging (MRI) is frequently used to visualize edema of the peripatellar fat pads due to injury. In this study, we aimed to assess the relationship between peripatellar fat pad edema and patellofemoral maltracking MRI parameters and investigate the association among cases of peripatellar fat pad edema. METHODS Age- and sex-matched peripatellar fat pad edema cases were identified and divided into superolateral Hoffa, quadriceps, and prefemoral groups. Images were assessed according to tibial tuberosity lateralization, trochlear dysplasia, patellar alta, patellar tilt, and bisect offset. McNemar's test or paired t-tests and Spearman's correlation were used for statistical analysis. Interobserver agreement was assessed with the intraclass correlation coefficient. RESULTS Of 1210 MRI scans, 50, 68, and 42 cases were in the superolateral Hoffa, quadriceps, and prefemoral groups, respectively. Subjects with superolateral Hoffa fat pad edema had a lower lateral trochlear inclination (p = 0.028), higher Insall-Salvati (p < 0.001) and modified Insall-Salvati (p = 0.021) ratios, and lower patellotrochlear index (p < 0.001) than controls. The prefemoral group had a lower lateral trochlear inclination (p = 0.014) and higher Insall-Salvati (p < 0.001) and modified Insall-Salvati (p = 0.004) ratios compared with the control group. In contrast, the patellotrochlear index (p = 0.001) was lower. Mean patellar tilt angle (p = 0.019) and mean bisect offset (p = 0.005) were significantly different between cases and controls. The quadriceps group showed no association. Superolateral Hoffa was positively correlated with prefemoral (p < 0.001, r = 0.408) and negatively correlated with quadriceps (p < 0.001, r = -0.500) fat pad edema. CONCLUSIONS Superolateral Hoffa and prefemoral fat pad edemas were associated with patellar maltracking parameters. Quadriceps fat pad edema and maltracking parameters were not associated. Superolateral Hoffa fat pad edema was positively correlated with prefemoral and negatively correlated with quadriceps fat pad edema.
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Affiliation(s)
- Liangjing Lyu
- Department of Radiology, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, No. 1111 Xianxia Road, Shanghai, 200336, China.
| | - Yongliang Li
- Department of Radiology, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, No. 1111 Xianxia Road, Shanghai, 200336, China
| | - Jingyu Zhong
- Department of Radiology, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, No. 1111 Xianxia Road, Shanghai, 200336, China
| | - Weiwu Yao
- Department of Radiology, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, No. 1111 Xianxia Road, Shanghai, 200336, China.
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Abelleyra Lastoria DA, Benny CK, Hing CB. Predisposing factors for Hoffa's fat pad syndrome: a systematic review. Knee Surg Relat Res 2023; 35:17. [PMID: 37296488 DOI: 10.1186/s43019-023-00192-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 05/29/2023] [Indexed: 06/12/2023] Open
Abstract
BACKGROUND Hoffa's fat pad syndrome has been defined as impingement of Hoffa's fat pad, leading to oedema and fibrosis. The primary aim of this systematic review was to identify morphological differences in Hoffa's fat pad between patients with and without Hoffa's fat pad syndrome, evaluating them as risk factors predisposing to its development. The secondary aim was to summarize and evaluate current evidence pertaining to the management of Hoffa's fat pad syndrome. MATERIALS AND METHODS The protocol for this review was prospectively registered (PROSPERO registration: CRD42022357036). Electronic databases, currently registered studies, conference proceedings and the reference lists of included studies were searched. All studies evaluating differences in Hoffa's fat pad anatomy under imaging between patients with and without Hoffa's fat pad syndrome were included, as well as those exploring epidemiological factors predisposing to its development (ethnicity, employment status, sex, age and BMI), and studies reporting on the effect of treatment on Hoffa's fat pad morphology. RESULTS A total of 3871 records were screened. Twenty one articles satisfied the inclusion criteria, evaluating 3603 knees of 3518 patients. Patella alta, increased tibial tubercle-tibial groove distance, and increased trochlear angle were found to predispose the development of Hoffa's fat pad syndrome. Trochlear inclination, sulcus angle, patient age and BMI were not associated with this condition. The link between Hoffa's fat pad syndrome and ethnicity, employment, patellar alignment, Hoffa's fat pad composition, physical activity and other pathological processes cannot be established due to lack of evidence. No studies reporting on treatment for Hoffa's fat pad syndrome were identified. Though weight loss and gene therapy may provide symptomatic relief, further research is required to corroborate these claims. CONCLUSION Current evidence suggests that high patellar height, TT-TG distance, and trochlear angle predispose the development of Hoffa's fat pad syndrome. In addition, trochlear inclination, sulcus angle, patient age and BMI do not seem to be associated with this condition. Further research should explore the link between Hoffa's fat pad syndrome and sport as well as other conditions pertaining to the knee. In addition, further study evaluating treatment approaches for Hoffa's fat pad syndrome is required.
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Affiliation(s)
| | | | - Caroline Blanca Hing
- Department of Trauma and Orthopaedics, St George's University Hospitals NHS Foundation Trust, London, UK
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He J, Ba H, Feng J, Peng C, Liao Y, Li L, Cao X, Wang Z, Shen M, Wu S. Increased signal intensity, not volume variation of infrapatellar fat pad in knee osteoarthritis: A cross-sectional study based on high-resolution magnetic resonance imaging. J Orthop Surg (Hong Kong) 2022; 30:10225536221092215. [PMID: 35422165 DOI: 10.1177/10225536221092215] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Infrapatellar fat pad (IPFP) is regarded as an essential knee tissue involved in osteoarthritis (OA) for its potential structural-related or metabolism-related function. This cross-sectional study aims to identify which part is more related to OA. METHODS Patients with knee OA (n = 53) and healthy controls (n = 54) were prospectively recruited. Based on high-resolution magnetic resonance imaging with a slice thickness of only 0.35 mm, IPFP structural-related parameters (volume and maximal area), metabolism-related parameter (signal), degeneration indicators, and patellar maltracking indicators (patellar translation, patellofemoral angle, and Insall-Salvati ratio) were measured. IPFP volume (maximal area, and signal) was compared between healthy controls and OA patients. The level of significance for all comparisons was set as .05. RESULTS OA patients had higher IPFP signal (672.9 ± 136.9 vs 567.3 ± 63.6, p = .009), but no significant difference in IPFP volume or maximal area compared with healthy controls. In healthy controls, IPFP signal was positively associated with age (β = 1.481; 95% CI: 0.286-2.676; p = .018); IPFP maximal area was positively related to Insall-Salvati ratio (β = 0.001; 95% CI: 0.0003-0.0017; p = .039), but not associated with patellar translation and patellofemoral angle. In OA patients, IPFP signal was positively associated with cartilage loss (β = 0.005; 95% CI: 0.003-0.007; p = .013); no correlation between knee pain and IPFP volume or maximal area was observed. CONCLUSIONS The metabolism-related function of IPFP, which can be reflected by the IPFP signal, might play a more critical role in OA progression than its structural function.
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Affiliation(s)
- Jinshen He
- Department of Orthopaedic Surgery, 504354Third Xiangya Hospital of Central South University, Changsha, China
| | - Hongliang Ba
- Department of Orthopaedic Surgery, 504354Third Xiangya Hospital of Central South University, Changsha, China
| | - Jing Feng
- Department of Orthopaedic Surgery, 504354Third Xiangya Hospital of Central South University, Changsha, China
| | - Cheng Peng
- Department of Burns, 504354Third Xiangya Hospital of Central South University, Changsha, China
| | - Yunjie Liao
- Department of Radiology, 504354Third Xiangya Hospital of Central South University, Changsha, China
| | - Lifeng Li
- Department of Radiology, 504354Third Xiangya Hospital of Central South University, Changsha, China
| | - Xu Cao
- Department of Orthopaedic Surgery, 504354Third Xiangya Hospital of Central South University, Changsha, China
| | - Zili Wang
- Department of Orthopaedic Surgery, 504354Third Xiangya Hospital of Central South University, Changsha, China
| | - Minren Shen
- Department of Orthopaedic Surgery, 504354Third Xiangya Hospital of Central South University, Changsha, China
| | - Song Wu
- Department of Orthopaedic Surgery, 504354Third Xiangya Hospital of Central South University, Changsha, China
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Ormeci T, Turkten I, Sakul BU. Radiological evaluation of patellofemoral instability and possible causes of assessment errors. World J Methodol 2022; 12:64-82. [PMID: 35433342 PMCID: PMC8984217 DOI: 10.5662/wjm.v12.i2.64] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 10/27/2021] [Accepted: 02/10/2022] [Indexed: 02/06/2023] Open
Abstract
Patellofemoral instability (PI) is the disruption of the patella’s relationship with the trochlear groove as a result of abnormal movement of the patella. To identify the presence of PI, conventional radiographs (anteroposterior, lateral, and axial or skyline views), magnetic resonance imaging, and computed tomography are used. In this study, we examined four main instability factors: Trochlear dysplasia, patella alta, tibial tuberosity–trochlear groove distance, and patellar tilt. We also briefly review some of the other assessment methods used in the quantitative and qualitative assessment of the patellofemoral joint, such as patellar size and shape, lateral trochlear inclination, trochlear depth, trochlear angle, and sulcus angle, in cases of PI. In addition, we reviewed the evaluation of coronal alignment, femoral anteversion, and tibial torsion. Possible causes of error that can be made when evaluating these factors are examined. PI is a multi-factorial problem. Many problems affecting bone structure and muscles morphologically and functionally can cause this condition. It is necessary to understand normal anatomy and biomechanics to make more accurate radiological measurements and to identify causes. Knowing the possible causes of measurement errors that may occur during radiological measurements and avoiding these pitfalls can provide a more reliable road map for treatment. This determines whether the disease will be treated medically and with rehabilitation or surgery without causing further complications.
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Affiliation(s)
- Tugrul Ormeci
- Department of Radiology, School of Medicine, İstanbul Medipol University, Istanbul 34200, Turkey
| | - Ismail Turkten
- Department of Anatomy, School of Medicine, İstanbul Medipol University, Istanbul 34820, Beykoz, Turkey
| | - Bayram Ufuk Sakul
- Department of Anatomy, School of Medicine, İstanbul Medipol University, Istanbul 34820, Beykoz, Turkey
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Jarraya M, Roemer FW, Engebretsen L, Kompel AJ, Small KM, Smith SE, Guermazi A. Association of markers of patellofemoral maltracking to cartilage damage and bone marrow lesions on MRI: Data from the 2016 Olympic Games of Rio De Janeiro. Eur J Radiol Open 2021; 8:100381. [PMID: 34660850 PMCID: PMC8502704 DOI: 10.1016/j.ejro.2021.100381] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Revised: 09/20/2021] [Accepted: 09/27/2021] [Indexed: 12/03/2022] Open
Abstract
Background Patellofemoral joint (PFJ) disease is a common ailment in elite athletes. Our aim is to report the frequency of superolateral Hoffa’s fat pad (SHFP) edema, and PFJ cartilage damage and bone marrow lesions (BML), among Olympian athletes, and to study the association between measurements of trochlear morphology and vertical patellar position and a) PFJ cartilage damage or BML, and b) SHFP edema. Methods All knee MRI, performed in the Olympic Village and polyclinics, of participating athletes in the 2016 Olympic Games of Rio de Janeiro were included. MRI were scored for PFJ cartilage damage and BML, and SHFP edema. Trochlear morphology measurements included sulcus angle, trochlear angle, lateral trochlear inclination, and medial trochlear inclination. Insall-Salvati ratio was also assessed. Results One hundred twenty-one knee MRIs were included (62 female, 51.2 %). The highest frequencies of PFJ cartilage damage, combination of PFJ cartilage damage and BML, and SHFP edema were found among Beach Volleyball and Volleyball athletes. SHFP edema was more common among female compared to male Olympian athletes. We found no statistically significant associations between different measurements of trochlear morphology/vertical patellar position, and 1. SHFP edema, and 2. PFJ cartilage damage/BML. Conclusion SHFP edema and the combination of PFJ cartilage damage and BML are highly frequent among Olympic athletes especially those competing in Beach volleyball and Volleyball. SHFP edema is more common among female athletes. Further studies are needed to determine whether PFJ cartilage damage has a stronger association to sports disciplines rather than trochlear morphology.
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Affiliation(s)
- Mohamed Jarraya
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Frank W Roemer
- Department of Radiology, Boston University School of Medicine, Boston, MA, United States.,Department of Radiology, Friedrich Alexander University Erlangen-Nürnberg (FAU) & Universitätsklinikum Erlangen, Erlangen, Germany
| | - Lars Engebretsen
- Medical and Scientific Department, International Olympic Committee, Lausanne, Switzerland.,Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway.,Department of Orthopedic Surgery, Oslo University Hospital, University of Oslo, Norway
| | - Andrew J Kompel
- Department of Radiology, Boston University School of Medicine, Boston, MA, United States
| | - Kirstin M Small
- Department of Radiology, Brigham and Women's Hospital, Boston, MA, United States
| | - Stacy E Smith
- Department of Radiology, Brigham and Women's Hospital, Boston, MA, United States
| | - Ali Guermazi
- Department of Radiology, Boston University School of Medicine, Boston, MA, United States.,Department of Radiology, VA Boston Health System, Boston, MA, United States
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Li J, Sheng B, Qiu L, Yu F, Lv FJ, Lv FR, Yang H. A quantitative MRI investigation of the association between iliotibial band syndrome and patellofemoral malalignment. Quant Imaging Med Surg 2021; 11:3209-3218. [PMID: 34249647 DOI: 10.21037/qims-20-1101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Accepted: 03/10/2021] [Indexed: 11/06/2022]
Abstract
Background The iliotibial band (ITB) has a wide patellar insertion that provides lateral restraint to the patella and maintains the patellofemoral joint's stability. There has been limited investigation into the relationship between patellofemoral malalignment and iliotibial band syndrome (ITBS). Methods We retrospectively analyzed 47 knees with ITBS by retrieving magnetic resonance imaging (MRI) data collected over an approximately 6-year period from our database. The Insall-Salvati ratio, lateral patellofemoral angle (LPA), lateral patellar tilt (LPT), lateral trochlear length (LTL), angle of the non-weight-bearing facet of the lateral femoral condyle (nwb-LFCA), and the ITB-lateral femoral condyle (IT-LFC) distance were measured on MR images. The knees of 47 age- and gender-matched subjects were enrolled as the normal group. Results In the ITBS group, over one third (34%, 16/47) of knees had abnormal patellofemoral measurements, including 8 (17%, 8/47) knees with patellar alta, 11 (23.4%, 11/47) knees with an abnormally decreased LPA, and 5 (10.6%, 5/47) knees with an abnormally increased LPT indicating lateral patellar tilt. Moreover, 8 knees had simultaneous combinations of two or three abnormality parameters, and 8 (17%, 8/47) knees presented with superolateral Hoffa's fat pad edema. The Insall-Salvati ratio, LPT, and nwb-LFCA in the ITBS group were significantly higher than those in the normal group (P=0.001, P<0.001, and P<0.001, respectively); the LPA and IT-LFC distances in the ITBS group were significantly lower (P=0.003, P<0.001, respectively) than those in the normal group. There were mild to moderate correlations between the MRI parameters and ITBS (P=0.006, P<0.001, respectively). Conclusions This study confirmed that a higher position or lateral tilt of the patella and a steeper morphology of the anterior part of the lateral femoral condyle were associated with the development of ITBS, which is helpful in understanding and further exploring the mechanism of ITBS.
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Affiliation(s)
- Jia Li
- Department of Radiology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Bo Sheng
- Department of Radiology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Lanyu Qiu
- Department of Radiology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Fan Yu
- Department of Radiology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Fa-Jin Lv
- Department of Radiology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Fu-Rong Lv
- Department of Radiology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Haitao Yang
- Department of Radiology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Maas KJ, Warncke ML, Leiderer M, Krause M, Dust T, Frings J, Frosch KH, Adam G, Henes FOG. Diagnostic Imaging of Patellofemoral Instability. ROFO-FORTSCHR RONTG 2021; 193:1019-1033. [PMID: 33773517 DOI: 10.1055/a-1348-2122] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Throughout the literature, patellofemoral instability (PI) is defined as an increased risk of re-/luxation of the patella within the patellofemoral joint (PFJ). In most patients it is caused by traumatic patella luxation or the existence of a range of predisposing anatomic risk factors leading to an unphysiological movement sequence within the PFJ also known as patellofemoral maltracking. In order to provide an individualized therapy approach, clinical and radiological evaluation of those risk factors of variable magnitude becomes essential. Diagnostic imaging such as magnetic resonance imaging (MRI), plain radiography, and computed tomography (CT) are straightforward diagnostic tools in terms of evaluation and treatment of PI. METHOD In this review we performed a precise analysis of today's literature concerning the radiological evaluation of anatomic risk factors leading to PI. The purpose of the review is to present a logical compilation of the different anatomical risk factors causing PI and provide a straight overview of valuable radiological imaging techniques. RESULTS AND CONCLUSION PI is frequently based on a multifactorial disposition. The most relevant predisposing risk factors are trochlea dysplasia, rupture of the medial patellofemoral ligament (MPFL), patella alta, abnormal tibial tubercle to trochlea groove distance (TT-TG), femoral torsion deformities, and genu valgum. Although plain X-rays may provide basic diagnostic value, cross-sectional imaging (MRI, CT) is the standard radiological tool in terms of evaluation and detection of severity of predisposing anatomic variants leading to PI. KEY POINTS · Based on today's literature, PI is characterized as an increased risk of patella re-/luxation within the PFJ.. · Underlying anatomic risk factors of variable magnitude mark the pathological cause of PI.. · Modern diagnostic imaging (MRI and CT) permits straightforward diagnosis of the typical features in terms of PI.. · To provide an individualized therapy approach, precise radiological evaluation and determination of the severity of predisposing anatomic anomalies are essential.. CITATION FORMAT · Maas KJ, Warncke ML, Leiderer M et al. Diagnostic Imaging of Patellofemoral Instability. Fortschr Röntgenstr 2021; 193: 1019 - 1033.
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Affiliation(s)
- Kai-Jonathan Maas
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Malte Lennart Warncke
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Miriam Leiderer
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Matthias Krause
- Department Trauma Surgery and Orthopedics, UKE, Hamburg, Germany
| | - Tobias Dust
- Department Trauma Surgery and Orthopedics, UKE, Hamburg, Germany
| | - Jannik Frings
- Department Trauma Surgery and Orthopedics, UKE, Hamburg, Germany
| | | | - Gerhard Adam
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Frank Oliver Gerhard Henes
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Editor's Notebook: September 2020. AJR Am J Roentgenol 2020; 215:521-522. [DOI: 10.2214/ajr.20.23998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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