Ultrasound of the Knee: Common Pathology Excluding Extensor Mechanism

Jacobson, Jon A.; Ruangchaijatuporn, Thumanoon; Khoury, Viviane; Magerkurth, Olaf

doi:10.1055/s-0037-1599204

Cited by 7 publications

(13 citation statements)

References 80 publications

(104 reference statements)

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“…Dynamic US examination of the medial structures of the knee has been proven to be a suitable method to describe medial joint space width [8, 12, 21, 25, 32]. It has been shown that the US examination is a good alternative to valgus stress radiographs, as it is radiation‐free [11, 25], easy to learn [8], cheap, and allows for a dynamic assessment of the medial joint space [8, 12]. Combined with a fixation device, standardized and reproducible measurements of the medial joint width [8] are possible.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound-based examination of the medial ligament complex shows gender- and age-related differences in laxity

Lutz¹,

Feucht

Wechselberger

et al. 2020

Knee Surg Sports Traumatol Arthrosc

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Purpose Ultrasound (US) examination of the medial joint space of the knee has played a subordinate diagnostic role up till now. The purpose of the present study was to describe mean values of medial joint width and to investigate the impact of gender, age, and body mass index (BMI) on medial joint laxity in healthy knees using modern, dynamic US in a standardized fashion in unloaded and standardized loaded conditions. Methods A total of 65 subjects with 79 healthy knees were enrolled in this study. All volunteers underwent clinical examination of the knee. The medial knee joint width was determined using US in a supine position at 0° and 30° of knee flexion in unloaded and standardized loaded (= 15 Dekanewton, daN) conditions using a specific device. Mean values were described and correlations between medial knee joint width and gender, age, and BMI were assessed. Results Thirty-two females and 33 males were enrolled in this study. The mean medial joint width in 0° unloaded was 5.7 ± 1.2 mm and 7.4 ± 1.4 mm loaded. In 30° of knee flexion, the mean medial joint width was 6.1 ± 1.1 mm unloaded and 7.8 ± 1.2 mm loaded. The average change between unloaded and loaded conditions in 0° was 1.7 ± 1.0 mm and in 30° 1.7 ± 0.9 mm. A significant difference between genders was evident for medial joint width in 0° and 30° of flexion in unloaded and loaded conditions (p < 0.05). With rising age, a significant increased change of medial joint space width between unloaded and loaded conditions could be demonstrated in 0° (p = 0.032). No significant correlation between BMI and medial joint width in US could be found. Conclusion Mean values of medial joint width in unloaded and standardized loaded conditions using a fixation device could be demonstrated. Based on the results of this study, medial knee joint width in US is gender- and age-related in healthy knees. These present data may be useful for evaluating patients with acute or chronic pathologies to the medial side of the knee. Level of evidence III.

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Section: Discussionmentioning

confidence: 99%

Ultrasound-based examination of the medial ligament complex shows gender- and age-related differences in laxity

Lutz¹,

Feucht

Wechselberger

et al. 2020

Knee Surg Sports Traumatol Arthrosc

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“…US is an excellent imaging modality for the evaluation of superficial soft tissue structures. 21 , 22 Direct correlation with the site of pain and comparison with the controlateral normal side are some of the advantages of US. For the evaluation of medial structures, it is important to identify the medial epicondyle as a femoral bony landmark.…”

Section: Imagingmentioning

confidence: 99%

“…For the evaluation of medial structures, it is important to identify the medial epicondyle as a femoral bony landmark. 21 The examination of the medial compartment is conducted at 30° of flexion. Voluntary external rotation facilitates visualization of the medial knee side.…”

Section: Imagingmentioning

confidence: 99%

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Posterior oblique ligament of the knee: state of the art

et al. 2021

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The posterior oblique ligament (POL) is the predominant ligamentous structure on the posterior medial corner of the knee joint. A thorough understanding of the anatomy, biomechanics, diagnosis, treatment and rehabilitation of POL injuries will aid orthopaedic surgeons in the management of these injuries. The resulting rotational instability, in addition to valgus laxity, may not be tolerated by athletes participating in pivoting sports. The most common mechanism of injury – accounting for 72% of cases – is related to sports activity, particularly football, basketball and skiing. Moreover, three different injury patterns have been reported: those associated with injury to the capsular arm of the semimembranosus (SM), those involving a complete peripheral meniscal detachment and those involving disruption of the SM and peripheral meniscal detachment. The hallmark of an injury related to POL lesions is the presence of anteromedial rotatory instability (AMRI), which is defined as ‘external rotation with anterior subluxation of the medial tibial plateau relative to the distal femur’. In acute settings, POL lesions can be easily identified using coronal and axial magnetic resonance imaging (MRI) where the medial collateral ligament (MCL) and POL appear as separate structures. However, MRI is not sensitive in chronic cases. Surgical treatment of the medial side leads to satisfactory clinical results in a multi-ligamentous reconstruction scenario, but it is known to be associated with secondary stiffness. In young patients with high functional demands, return to sports is allowed no earlier than 9–12 months after they have undergone a thorough rehabilitation programme. Cite this article: EFORT Open Rev 2021;6:364-371. DOI: 10.1302/2058-5241.6.200127

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“…For ankle effusion, planes in the longitudinal and transversal axis of the talocrural joint were assessed. (Gaulrapp;Jacobson, Ruangchaijatuporn, Khoury, & Magerkurth, 2017;Kane, Balint, & Sturrock, 2003;Terslev et al, 2012) The effusion was graded 0-3 according to Hartung et al -an ultrasound score originally developed for patients with rheumatoid arthritis, which has also been used to evaluate other populations, including marathon runners. (Hartung et al, 2012;Proft et al, 2016).…”

Section: Sonographymentioning

confidence: 99%

Significant effusion in the joints of the lower extremity after running an ultramarathon in extreme conditions

Steinmetz

Höller

Hubert

et al. 2019

jhse

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Introduction:The "Brocken challenge" ultramarathon takes place in the cold of February over 80 km with 1,900 m of elevation change. The purpose of this study was to evaluate the effects of an ultramarathon under extreme conditions on the lower extremities. Methods: Out of the 182 starters, 44 athletes were included into the study (n=44). We examined these athletes using a questionnaire, by measuring circumferences of their lower extremities and by standardized sonographic measurement of joint effusion of knee and ankle joints before and after the run. Results: After the run, the right leg and both feet significantly increased in circumference. Knee joints on both sides and the left ankle joint showed significantly more effusion after the run (right knee: 84%, right ankle: 43%; left knee: 80%, left ankle: 48%). Heavier and less trained athletes showed significantly more effusion in sonographic assessment of the knee and ankle. Neither swelling, nor effusion had a measurable influence on finishing time. Conclusions: Running an ultramarathon in the cold overloads the fluid draining capacity in the muscles and joints of the legs especially in heavier and less trained athletes without measurable immediate effect on performance.

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Ultrasound of the Knee: Common Pathology Excluding Extensor Mechanism

Cited by 7 publications

References 80 publications

Ultrasound-based examination of the medial ligament complex shows gender- and age-related differences in laxity

Ultrasound-based examination of the medial ligament complex shows gender- and age-related differences in laxity

Posterior oblique ligament of the knee: state of the art

Significant effusion in the joints of the lower extremity after running an ultramarathon in extreme conditions

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