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Patellar instability: CT and MRI measurements and their correlation with internal derangement findings

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

To test the inter-observer and inter-method reliability among the measures suggesting patellofemoral joint disorder on both CT and MRI in the same subject and find possible association with internal derangements of the patellofemoral joint on MRI.

Methods

Institutional review board approval was obtained with waiver of the informed consent in this HIPPA-compliant study. CT and MRI were evaluated in 32 knees in 32 respective subjects (10 men/22 women, mean age 38 ± 19 years). Three trained observers assessed tibial tuberosity–trochlear groove (TT–TG) distance, trochlear angle and trochlear depth on both CT and MRI. Intra-class correlation coefficient (ICC) was used to evaluate inter-observer and inter-method reliability. Two radiologists’ consensus reading was used to evaluate their association with soft tissue abnormalities of the patellofemoral joint. Chi-square test was used to assess the statistical significance of the qualitative variables.

Results

There was an excellent inter-observer reliability (ICC for CT >0.89 and for MRI >0.90) and inter-method reliability (ICC >0.86) for all the quantitative measurements. There was a significant association between increased TT–TG distance value on MR imaging and lateral facet patellar cartilage abnormality and joint effusion (p < 0.05).

Conclusion

Quantitative trochlear parameters can be reliably calculated on MRI, and an abnormal TT–TG distance is the most useful measurement among various static MR imaging parameters to correlate with patellar chondrosis and joint effusion. TT–TG distance should be reported in patellofemoral pain syndrome patients.

Level of evidence

IV.

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Acknowledgments

Avneesh Chhabra acknowledges the support of research grants from Siemens AG and Integra Life Sciences as well as the support of a GERRAF and GE-AUR Fellowship. John A. Carrino acknowledges grant from Siemens Medical Systems. Filippo Del Grande acknowledges institutional grant from Siemens and GE shareholder.

Conflict of interest

The other authors report no conflicts of interest.

Author information

Authors and Affiliations

  1. The Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins Hospital, 601 N. Caroline Street, Baltimore, MD, 21287, USA

    Rashmi S. Thakkar, Filippo Del Grande, Majid Chalian, John A. Carrino, John Eng & Avneesh Chhabra

  2. Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, AR, USA

    Vibhor Wadhwa

  3. Department of Radiology, University Hospital, Zurich, Switzerland

    Gustav Andreisek

Authors
  1. Rashmi S. Thakkar
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  2. Filippo Del Grande
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  3. Vibhor Wadhwa
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  4. Majid Chalian
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  5. Gustav Andreisek
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  6. John A. Carrino
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  7. John Eng
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  8. Avneesh Chhabra
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Correspondence to Avneesh Chhabra.

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Thakkar, R.S., Del Grande, F., Wadhwa, V. et al. Patellar instability: CT and MRI measurements and their correlation with internal derangement findings. Knee Surg Sports Traumatol Arthrosc 24, 3021–3028 (2016). https://doi.org/10.1007/s00167-015-3614-8

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  • DOI: https://doi.org/10.1007/s00167-015-3614-8

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