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Bildgebende Untersuchungen des Patellofemoralgelenks

Imaging examinations of the patellofemoral joint

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Zusammenfassung

Die Ursachen für Läsionen im Bereich des Femoropatellargelenks sind mannigfaltig. Neben traumatischen Ereignissen und chronischen Überlastungen sind insbesondere Abnützungen im Rahmen eines Fehlgleitens oder auch entzündliche Erkrankungen zu erwähnen. Denn nicht selten kommt es dadurch zu frühzeitigen Arthrosen. Eine exakte klinische Abklärung ist bei allen Patienten mit vorderem Knieschmerz und mit Verdacht auf pathologische Kniegelenkveränderungen unbedingt zu fordern. Zusammen mit der entsprechend klinischen Information und Ergebnissen radiologischer Untersuchungen lässt sich eine genaue Diagnose erstellen.

Im Rahmen der radiologischen Abklärung des anterioren Knieschmerzes und nach posttraumatischen Ereignissen kommt sicherlich der Magnetresonanztomographie (MRT) eine sehr hohe Wertigkeit zu. Sie erlaubt eine direkte Darstellung der in Frage kommenden pathologischen oder verletzten Strukturen und hilft so, ein suffizientes therapeutisches Prozedere zu planen. Darüber hinaus kommt der MRT bei klinischem Verdacht auf eine Läsion oder Verletzung eine nicht unwesentliche Bedeutung zu. Sollte sich die Verdachtsdiagnose bei unauffälligem MRT-Befund nicht bestätigen, kann von einer weitreichenden Behandlung und insbesondere chirurgischen Eingriffen Abstand genommen werden kann. In diesem Beitrag werden die wichtigsten bildgebenden Verfahren zur Evaluierung der patellofemoralen Region kurz vorgestellt und insbesondere die Wertigkeit der MRT beschrieben.

Abstract

Lesions in the patellofemoral region can be caused by trauma, chronic overloading, and especially regarding cartilage alterations by normal aging or pathologic processes. Very commonly these lesions lead to early arthrosis. An accurate clinical evaluation in all these patients is recommended. The combination of clinical information and radiological examinations should end up with an exact diagnosis.

As part of the radiological evaluation of complaints of the patellofemoral region MR imaging is of special value since this method allows direct visualization of all intra- and extra-articular structures and their alterations, ultimately aiding in planning sufficient therapy. Moreover, is it possible to exclude pathology by MR imaging, which helps to prevent useless treatment and surgical procedures.

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Authors and Affiliations

  1. Institut für CT & MRT Diagnostik am Schillerpark, Rainerstraße 6-8, A-4020, Linz, Österreich

    J. Kramer, G. Scheurecker, A. Scheurecker, A. Stöger & H. Huber

  2. Allgemeines und Orthopädisches LKH - Stolzalpe, Stolzalpe, Österreich

    S. Hofmann

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  1. J. Kramer
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  2. G. Scheurecker
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  3. A. Scheurecker
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  4. A. Stöger
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  5. H. Huber
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  6. S. Hofmann
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Correspondence to J. Kramer.

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Kramer, J., Scheurecker, G., Scheurecker, A. et al. Bildgebende Untersuchungen des Patellofemoralgelenks. Orthopäde 37, 818–834 (2008). https://doi.org/10.1007/s00132-008-1288-3

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