Diffusely increased bone scintigraphic uptake in patellofemoral pain syndrome

Abstract

Objectives: Painful disorders of the patellofemoral joint are one of the most frequent complaints in orthopaedic and sports medicine. The aims of this study were to determine whether bone scintigrams of patients suffering from patellofemoral pain syndrome (PFPS) show diffuse uptake and in what bony compartment of the knee uptake, if any, was localised. Methods: Fifty eight patients with chronic PFPS were examined. All patients underwent a detailed clinical history and a thorough physical examination of the knee. Anterior and lateral static images of both knees were made using a gamma camera 3 h after injection of 550 MBq of 99m Tc-HMDP. Two experienced radiologists visually evaluated the scans blindly and separately. As 51 patients had bilateral pain, 109 painful knees are included in the results. Results: Diffuse uptake on bone scintigrams was found in 48 knees in 30 of the patients. In 33 knees the uptake was localised to only one bone compartment, in 10 knees diffuse uptake was found in two of the bones forming the knee joint, and in six knees all three bone compartments (the distal femur, the patella, and the proximal tibia) exhibited diffuse uptake. Conclusions: Scintigrams of approximately half of the patients with PFPS will show diffuse uptake in one or more of the bony compartments of the knee joint and radioactive tracer accumulation will occur as often in the proximal tibia as in the patella.

Patellofemoral Pain in Adolescence and Adulthood: Same Same, but Different?

“…Recently, imaging data from patients with PFP have been published using newer imaging modalities and technologies in hope that these modalities are more sensitive to detect any possible pathology related to the cartilage under the patella and in the patellar groove. Positron emission tomography-computed tomography (PET-CT) imaging shows that 44-85 % of older adults (mean age [29][30][31][32][33][34] with PFP show increased tracer uptake in the patellofemoral joint that tends to coincide with bone marrow oedema, subchondral bone cysts, and cartilage damage [45][46][47]. Furthermore, there appears to be an association between the tracer uptake and pain intensity, and an association between pain location and location of tracer uptake that suggests an aetiological link [46].…”

Hip Strength and Hip and Knee Kinematics During Stair Descent in Females With and Without Patellofemoral Pain Syndrome

“…Excessive knee valgus from hip adduction (movement of the femur relative to the pelvis) increases the Q-angle because it displaces P atellofemoral pain syndrome (PFPS) is a common problem experienced by active adults and adolescents 31 ; however, its etiology has remained vague and controversial. 22 Unlike other knee dysfunctions (eg, anterior cruciate ligament injury), which often have a specific onset and mechanism of injury, patients with PFPS generally report diffuse peripatellar and retropatellar pain of an insidious onset. Dye 9 has described PFPS as an orthopedic " the patella medially relative to the tibial tubercle.…”

Diagnosis and treatment of anterior knee pain

“…Additionally, an association between restoration to normality of the bone scan and the resolution of AKP after conservative treatment has also been documented 18. Näslund et al 47 found that nearly 50% of patients with AKP show a diffuse uptake in the scintigraphy in one or more of the bony compartments of the knee joint.…”