Summary
Recent clinical and epidemiological studies have emphasised the importance of the patello-femoral joint (P-FJ) in osteoarthritis. X-ray examination of this joint for joint space width (JSW) assessment using the standard medio-lateral view is difficult. In 26 femora, the mean angle of inclination between the medial and lateral condyles measured at their inferior and anterior surfaces, relative to a line passing between the medial and lateral femoral epicondyles, was used to define the optimum alignment of the x-ray tube. The results showed that for medio-lateral radiography of the P-FJ, the central ray of the x-ray beam should be directed cranially, in a upward projection by 5° and then anteriorly by 4°, resulting in superimposition of the inferior and anterior condylar surfaces respectively. The value of these angles was confirmed by radiographs of the 26 femora and 10 post mortem joints. The margins for joint space width measurement were identified by embedding lead balls, within the cartilage of the cadaveric knees, and were defined as the median vertical ridge of the patella and the middle of the patella groove on the femur.
Résumé
De récentes études cliniques et épidémiologiques ont souligné l'importance de l'articulation fémoropatellaire (AFP) dans l'arthrose du genou. L'examen radiographique de cette articulation, notamment pour l'appréciation de l'épaisseur de l'interligne articulaire en incidence médiolatérale de routine, est difficile. Sur 26 fémurs, l'angle moyen d'inclinaison des surfaces inférieure et antérieure des condyles latéral et médial par rapport à une ligne unissant les deux épicondyles a été utilisé pour définir l'alignement optimal du tube radiogène. Les résultats ont montré que pour une radiographie médio-latérale de l'AFP, le faisceau central de rayons X devait être dirigé crânialement de 5°, et antérieurement de 4°, permettant ainsi d'obtenir la superposition des deux condyles. La validité de ces angles a été confirmée par les radiographies de 26 fémurs et de 10 articulations cadavériques. Les repères pour la mesure de l'épaisseur de l'interligne articulaire, identifiés par l'insertion de billes de plomb dans le cartilage des articulations cadavériques, ont été définis comme étant la crête verticale médiane de la patella et le milieu de la gorge patellaire du fémur.
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Szebenyi, B., Dieppe, P. & Buckland-Wright, J. Radio-anatomic position for the lateral radiographic view of the human patello-femoral joint. Surg Radiol Anat 17, 79–81 (1995). https://doi.org/10.1007/BF01629506
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DOI: https://doi.org/10.1007/BF01629506