Reliability of Clinical Findings and Magnetic Resonance Imaging for the Diagnosis of Chondromalacia Patellae

Pihlajamäki, Harri; Kuikka, Paavo-Ilari; Leppänen, V.; Kiuru, Martti J.; Mattila, Ville M.

doi:10.2106/jbjs.h.01527

Cited by 74 publications

(65 citation statements)

References 23 publications

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“…The available measurements are inadequate in reflecting the actual patellar alignment, and studies have contradicting results regarding normal measurements of the congruence angles [20,21]. Arthroscopy is a reliable diagnostic method; however, surgical treatment for CMP is indicated in less than 10% of patients [22]. MRI is the imaging modality that should be chosen for non-interventional diagnosis of CMP [21].…”

Section: Discussionmentioning

confidence: 99%

Investigation of the Relationship between Anterior Knee Pain and Chondromalacia Patellae and Patellofemoral Malalignment

et al. 2018

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Objective:The study aimed to investigate whether there is any association of anterior knee pain and knee function with chondromalacia stage and patellofemoral alignment in patients with anterior knee pain for over a month and with chondromalacia patellae (CMP) detected by magnetic resonance imaging (MRI). Materials and Methods: We reviewed the medical records of 38 patients who underwent a knee MRI examination and were diagnosed with chondromalacia based on the MRI. Knee MRI images were evaluated by a radiologist for chondromalacia staging. Patients were divided into two groups as early stage (stage 1-2) and advanced stage (stage 3-4) chondromalacia. Patients' demographical data (age, sex, and occupation), clinical features, physical examination findings and patellofemoral pain severity scale, kujala patellofemoral scoring system, and functional index questionnaire scores were obtained from their medical records. Trochlear sulcus angle, sulcus depth, lateral patellofemoral angle, patellar translation, and Insall-Salvati index were measured using the MRI images. Results: The mean patient age was higher in the advanced stage CMP group compared to the early stage CMP group (p=0.038). There was no statistically significant difference regarding other demographical data (p>0.05). MRI measurement parameters did not show difference between the groups (p>0.05). Patients in the advanced stage CMP group had higher patellofemoral pain severity score, lower kujala patellofemoral score, and lower functional index questionnaire score compared to the early stage CMP group. The differences were statistically significant (p=0.008, p=0.012, and p=0.026, respectively). Conclusion: As chondromalacia stage advances, the symptom severity worsens and knee functions decline; however, MRI measurements do not show difference between early and advanced stage CMP patients.

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Section: Discussionmentioning

confidence: 99%

Investigation of the Relationship between Anterior Knee Pain and Chondromalacia Patellae and Patellofemoral Malalignment

et al. 2018

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“…MRI is a valuable tool because it provides 3-dimensional views, does not use ionizing radiation, and evaluates the bone as well as the soft tissues. Pihlajamaki [24] found that MRI was an accurate diagnostic tool for severe cases of chondromalacia patella although the sensitivity for low grade lesions was lower. However, this study used 1.0 Tesla magnets rather than the more detailed MRIs available currently.…”

Section: Imagingmentioning

confidence: 99%

Patellofemoral pain: an update on diagnostic and treatment options

McCarthy

Strickland

2013

Curr Rev Musculoskelet Med

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Patellofemoral pain is a frequent and often challenging clinical problem. It affects females more than males and includes many different pathologic entities that result in pain in the anterior aspect of the knee. Diagnosis of the specific cause of pain can be difficult and requires assessment of lower extremity strength, alignment, and range of motion, as well as specific patella alignment, tracking, and mobility. The treatment for patellofemoral pain is usually conservative with anti-inflammatory medications, activity modification, and a specific physical therapy program focusing on strengthening and flexibility. Infrequently, surgical treatment may be indicated after a non-operative program fails. The outcomes of surgical management may include debridement, lateral release, and realignment of the extensor mechanism to unload the patellofemoral articulation are favorable.

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“…4,8,11 Most of the studies have taken clinical presentation of anterior knee pain as a reference standard for suspecting PFPS and some have used knee arthroscopy as a reference standard. [4][5][6][7]12,13 We proposed that just a mere presentation of the anterior knee pain without other identifiable causes cannot label a patient as having PFPS. Arthroscopy for a condition like PFPS which is treated mostly by physiotherapy is not routinely justifiable as it is an invasive procedure and has its own complications.…”

Section: Discussionmentioning

confidence: 99%

Reliability of clinical methods in evaluating patellofemoral pain syndrome with malalignment

Arjun¹,

Kishan²,

Dhillon³

et al. 2017

Int J Res Orthop

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Background: Diagnosis of patellofemroal pain syndrome has been challenging due to lack of clinical test with better sensitivity and specificity, axial imaging has been considered as the standard modality for evaluation. Patients with anterior knee pain because of patellofemoral pain syndrome can be sub-grouped as those with or without radiological positive parameter for patellar maltracking. The aim of the present study was to evaluate reliability of clinical tests in two subgroups of patients presenting with patellofemoral pain syndrome.Methods: 45 knees with anterior knee pain without any episode of patellar instability were evaluated clinically using four standard tests (patellar apprehension test (PAT), eccentric step test (EST), active instability test (AIT) and Waldron’s test. On the basis of CT scan finding (at least one positive radiological parameter of instability) 28 knees were categorized in Group A (potential patellar instability group) and 17 knees in Group B (PFPS).Results: All patients with 3 or more than three clinical test positive were cases with potential patellofemroal instability except two. Whereas other true patellofemroal pain patients all except 2 were have less than 3 positive clinical tests. Conclusions: Clinical test have more diagnostic accuracy in evaluating anterior knee pain due to potential patellofemroal instability in comparison to patellofemroal pain without radiological instability.

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Reliability of Clinical Findings and Magnetic Resonance Imaging for the Diagnosis of Chondromalacia Patellae

Cited by 74 publications

References 23 publications

Investigation of the Relationship between Anterior Knee Pain and Chondromalacia Patellae and Patellofemoral Malalignment

Investigation of the Relationship between Anterior Knee Pain and Chondromalacia Patellae and Patellofemoral Malalignment

Patellofemoral pain: an update on diagnostic and treatment options

Reliability of clinical methods in evaluating patellofemoral pain syndrome with malalignment

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