Patellar Tendinitis: The Significance of Magnetic Resonance Imaging Findings

Abstract

We evaluated the significance of magnetic resonance imaging findings in patients with patellar tendinitis. Midline sagittal magnetic resonance images were taken of 12 knees from 10 patients and of 17 knees from 15 age- and activity-matched subjects who underwent imaging for reasons other than patellar tendinitis. Of the 12 magnetic resonance imaging scans of knees with clinical patellar tendinitis, 3 (25%) exhibited no defect and only 7 (58%) had unequivocal intratendinous lesions. Among the 17 scans of subjects without clinical patellar tendinitis, 5 (34%) showed no defect and 4 (24%) had unequivocal intratendinous lesions. Proximal tendon width was significantly larger for the tendinitis patient group (5.0 +/- 1.7 mm versus 3.9 +/- 1.0 mm), although considerable overlap was present. All subjects with unequivocal intratendinous signal changes had a significantly longer nonarticular inferior patellar pole and were significantly older (38.1 years versus 26.8 years). Only Blazina stage III lesions were associated with abnormal findings on magnetic resonance imaging. As a whole, the sensitivity and specificity of magnetic resonance imaging was 75% and 29%, respectively. In younger patients with relatively mild symptoms, magnetic resonance imaging did not show significant changes; in older, active patients changes may be present in asymptomatic knees.

Tendinopatia patelar

“…A hipótese de que o pólo inferior da patela pode influenciar o aparecimento da tendinopatia patelar foi reforçada com a existência de um pólo inferior longo da patela em pacientes com tendinopatia patelar (18)(19)(20) . Porém, o pólo inferior da patela longo pode, em verdade, representar um osteófito de tração, causado por determinada força de alta tensão repetitiva e pode não ser uma anormalidade preexistente que contribuiu para a tendinopatia patelar (19) .…”

“…Porém, o pólo inferior da patela longo pode, em verdade, representar um osteófito de tração, causado por determinada força de alta tensão repetitiva e pode não ser uma anormalidade preexistente que contribuiu para a tendinopatia patelar (19) . Indivíduos com tendinopatia patelar apresentam maior comprimento da tíbia em relação à estatura.…”

“…Com o uso contínuo do joelho em atividades físicas, a dor pode progredir, tornando-se freqüente durante as atividades, interferindo significativamente com o desempenho atlético (24) . Em alguns casos, pode evoluir, tornandose permanente, mesmo em repouso, manifestando-se como dor noturna que perturba o sono (19,22) . Outra queixa comum é a dor referida pelo paciente quando permanece com o joelho flexionado por longo período e ao subir e descer escadas (25) .…”

Acute and Chronic Tendon Injuries: Factors Affecting the Healing Response and Treatment

“…In chronic tendinitis the tendon is thickened, it is inhomogeneous and hypoechoic, the contour is altered, and intratendinous calcification is noted. 53,54 Although MRI 55 can be performed, ultrasound provides a structural analysis and a dynamic interactive examination. 54 In addition, ultrasound is fast, noninvasive, inexpensive, and readily available.…”

“…In some cases, surgery might not be an effective or reasonable option. 42,43 Studies on tendinitis and other soft-tissue injuries in humans have been limited and are based solely on results from MRI, 55 ultrasonography, 52 and return to competition after treatments with antiinflammatory drugs, 4,7,74,79 4,7,[70][71][72][73] Studies on rats and rabbits have provided interesting results. An increase in fibroblasts in rats with chemically induced tendinitis was seen after ASTM.…”