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- Title
MRI evaluation of anterior knee pain: predicting response to nonoperative treatment.
- Authors
Jocelyn Wittstein; Seth O’Brien; Emily Vinson; William Garrett
- Abstract
Abstract Objective Tibial tubercle lateral deviation and patellofemoral chondromalacia are associated with anterior knee pain (AKP). We hypothesized that increased tibial tubercle lateral deviation and patellofemoral chondromalacia on magnetic resonance imaging correlates with the presence of AKP and with failure of nonoperative management. Materials and methods In this retrospective comparative study, a blinded musculoskeletal radiologist measured tibial tubercle lateral deviation relative to the trochlear groove in 15 controls, 15 physical therapy responders with AKP, and 15 physical therapy nonresponders with AKP. Patellar and trochlear cartilage was assessed for signal abnormality, irregularity, and defects. Results The mean tibial tubercle lateral deviation in controls, physical therapy responders, and physical therapy nonresponders were 9.32 ± 0.68, 13.01 ± 0.82, and 16.07 ± 1.16 mm, respectively (data are mean ± standard deviation). The correlation coefficients for tubercle deviation, chondromalacia patellae, and trochlear chondromalacia were 0.51 (P P P Conclusion Subjects with AKP have more laterally positioned tibial tubercles and are more likely to have patellar chondromalacia. Patients with AKP, chondromalacia patellae, and a tubercle deviation greater than 14.6 mm are unlikely to respond to nonoperative treatment. Knowledge of tibial tubercle lateralization and presence of chondromalacia patellae may assist clinicians in determining patient prognosis and selecting treatment options.
- Subjects
KNEE diseases; MAGNETIC resonance imaging; TIBIA; PATELLOFEMORAL joint diseases; CHONDROMALACIA; THERAPEUTIC complications; STANDARD deviations; DIAGNOSIS
- Publication
Skeletal Radiology, 2009, Vol 38, Issue 9, p895
- ISSN
0364-2348
- Publication type
Article
- DOI
10.1007/s00256-009-0698-6