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Imaging of the Knee

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Musculoskeletal Diseases 2009–2012

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Abstract

Conventional radiographs are the initial radiologic study in most suspected knee disorders. Radiographs demonstrate the joint spaces as well as bones, but are relatively insensitive to soft-tissue (except those composed largely of calcium or fat), destruction of medullary bone, and early loss of cartilage. A minimum radiographic examination consists of AP and lateral projections. In patients with acute trauma, performing the lateral examination cross-table allows identification of a lipohemarthrosis, an important clue to the presence of an intraarticular fracture [1]. The addition of oblique projections increases the sensitivity of the examination for nondisplaced fractures, especially those of the tibial plateau [2]. For the early detection of articulai cartilage loss, a PA radiograph of both knees with the patient standing and knees mildly flexed is a useful adjunct projection. A joint space difference of 2 mm side-to-side correlates with grade III and higher chondrosis [3]. The tunnel projection is useful to demonstrate intercondylar osteophytes. In patients with anterior knee symptoms, an axial projection of the patellofemoral joint, such as a Merchant view, can evaluate the patellofemoral joint space and alignment [4].

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Authors and Affiliations

  1. Musculoskeletal Section, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA

    David A. Rubin

  2. Radiology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA

    Arthur A. De Smet

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  1. David A. Rubin
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Editors and Affiliations

  1. Radiology, Orthopedic University, Hospital Balgrist, Zurich, Switzerland

    J. Hodler

  2. Kilchberg, Switzerland

    Ch. L. Zollikofer

  3. Zurich, Switzerland

    Ch. L. Zollikofer

  4. Nuclear Medicine, University Hospital, Zurich, Switzerland

    G. K. Von Schulthess

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Rubin, D.A., De Smet, A.A. (2009). Imaging of the Knee. In: Hodler, J., Zollikofer, C.L., Von Schulthess, G.K. (eds) Musculoskeletal Diseases 2009–2012. Springer, Milano. https://doi.org/10.1007/978-88-470-1378-0_8

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