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BackgroundPatellar tendinopathy is a common cause of activity-related anterior knee pain. Evidence is conflicting as to whether obesity is a risk factor for this condition. The aim of this study was to determine the relationship between obesity and prevalence of magnetic resonance imaging (MRI) defined patellar tendinopathy in community-based adults.Methods297 participants aged 50–79 years with no history of knee pain or injury were recruited from an existing community-based cohort. Measures of obesity included measured weight and body mass index (BMI), self-reported weight at age of 18–21 years and heaviest lifetime weight. Fat-free mass and fat mass were measured using bioelectrical impedance. Participants underwent MRI of the dominant knee. Patellar tendinopathy was defined on both T1- and T2-weighted images.ResultsThe prevalence of MRI defined patellar tendinopathy was 28.3%. Current weight (OR per kg = 1.04, 95% CI 1.01-1.06, P = 0.002), BMI (OR per kg/m2 = 1.10, 95% CI 1.04-1.17, P = 0.002), heaviest lifetime weight (OR per kg = 1.03, 95% CI 1.01-1.05, P = 0.007) and weight at age of 18–21 years (OR per kg = 1.03, 95% CI 1.00-1.07, P = 0.05) were all positively associated with the prevalence of patellar tendinopathy. Neither fat mass nor fat-free mass was associated with patellar tendinopathy.ConclusionMRI defined patellar tendinopathy is common in community-based adults and is associated with current and past history of obesity assessed by BMI or body weight, but not fat mass. The findings suggest a mechanical pathogenesis of patellar tendinopathy and patellar tendinopathy may be one mechanism for obesity related anterior knee pain.

BackgroundPatellar tendinopathy identified by imaging modalities has been reported in asymptomatic athletes and associated with tendon-related symptoms. However there is little data in community-based populations. The aim of this cohort study was to examine the prevalence of magnetic resonance imaging (MRI) defined patellar tendinopathy, the factors associated with this condition, and whether it was associated with knee pain in community-based middle-aged women.MethodsOne hundred seventy six women, aged 40–67 years, with no significant knee pain or injury underwent knee MRI. Patellar tendinopathy was defined on both T1- and T2-weighted fat-saturated MRIs. The cross-sectional area of vastus medialis was measured from MRI. Height and weight were measured to calculate body mass index (BMI). Physical activity was assessed using a questionnaire. Knee pain was assessed using the Western Ontario and McMaster University Osteoarthritis Index.ResultsThe prevalence of MRI defined patellar tendinopathy was 30.1 %. Higher levels of physical activity (odds ratio 1.65, 95 % CI 1.09–2.51) and greater vastus medialis cross-sectional area (odds ratio 1.22, 95 % CI 1.04–1.43) were associated with increased prevalence of patellar tendinopathy, independent of age and BMI. The persistence of patellar tendinopathy was associated with the worsening of knee pain over 2 years (odds ratio 10.65, 95 % CI 1.14–99.77).ConclusionIn community-based middle-aged women MRI-diagnosed patellar tendinopathy is common, with higher levels of physical activity and greater vastus medialis size being risk factors suggesting a biomechanical effect. Persistent patellar tendinopathy is associated with worsening of knee pain. These findings suggest that further work is needed to determine the contribution of patellar tendinopathy on knee pain and function in older people.

The OF and PNF procedures provide comparable deformity correction for uncomplicated primary Dupuytren's disease in the immediate perioperative period. The reduced side effect profile of PNF should prompt surgeons to consider incorporating it in their practice for the first-line management of uncomplicated primary Dupuytren's disease.

Objectives: The purpose of this pilot study was to obtain an Australian perspective on evaluating the utility of plain film radiography and computed tomography (CT) to rule out fish bone impaction in the upper aerodigestive tract in the emergency department (ED) setting. Methods: A retrospective multicentre cohort study was conducted. A total of 73 patients met the inclusion criteria. A subgroup of patients underwent CT. We studied the sensitivity and specificity of x-ray and CT along with other demographic variables to determine the likelihood of true fish bone impaction. Results: Out of the 73 patients, 28 patients had true bone impaction. The sensitivity for x-ray was 42.9% and specificity was 73.3%. The sensitivity of CT was 87.5% and specificity was 71.4%. We found a significant difference in the mean age of presentation for true bone and false bone impaction, P = 0.02. Conclusion: Due to the low sensitivity of x-ray we do not recommend the utilisation of plain film radiography to rule out bone impaction Advances in low dose radiation multidetector CT scanners may replace plain film radiography as a screening tool.