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MRI criteria for patella alta and baja

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Abstract

Objective

To determine the range of the patellar tendon length to patellar length ratio on magnetic resonance imaging (MRI) of the knee in order to aid in the establishment of MRI criteria for patella alta and baja.

Patients

Two hundred and forty-five patients ages 6–85 (mean 44) years who went through 262 consecutive 1.5 MRI studies of the knee performed during November 2000 through February 2001 were evaluated, regardless of their clinical symptoms.

Design

Patellar length (PL) and patellar tendon length (TL) were measured by a single musculoskeletal radiologist on sagittal images by a line connecting the superior and inferior patellar poles and the shortest length of the inner margin of the tendon respectively. TL/PL ratio was subsequently calculated. The distribution of ratios was evaluated; the extreme 2.5% at each end of the distribution was defined as patella alta and baja.

Results

The TL/PL ratio ranged between 0.56 and 1.71 (mean 1.05). After plotting the ratios, we noted an asymmetric curve skewed to the left. Based upon calculation of the extreme 2.5% of the ratio at each end of the plot, we determined that the MRI definition of patella alta and baja is a ratio of TL/PL of more than 1.50 and less than 0.74 respectively. We found that females had significantly higher TL/PL ratio than males (1.0878 and 1.0032 respectively). Ratios defined for patella alta and baja were 1.52 and 0.79 respectively in females and 1.32 and 0.74 respectively in males (p<0.0001).

Conclusion

Patella alta and baja are determined as TL/PL of more than 1.50 and less than 0.74 respectively, somewhat different than traditionally quoted radiographic and previously described MRI criteria.

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References

  1. Grelsamer RP, Meadows S. The modified Insall–Salvati ratio for assessment of patellar height. Clin Orthop 1992; 282:170–176

    PubMed  Google Scholar 

  2. Miller TT, Staron RB, Feldman F. Patellar height on sagittal MR imaging of the knee. AJR 1996; 167:339–341

    CAS  PubMed  Google Scholar 

  3. Grana WA, Krieghauser LA. Scientific basis of extensor mechanism disorders. Clin Sports Med 1985; 4:247–257

    CAS  PubMed  Google Scholar 

  4. Insall J, Salvati E. Patella position in the normal knee joint. Radiology 1971; 101:101–104

    CAS  PubMed  Google Scholar 

  5. Kannus PA. Long patellar tendon: Radiographic sign of patellofemoral pain syndrome. Radiology 1992; 185:859–863

    CAS  PubMed  Google Scholar 

  6. Von Gumppenberg S, Jacob RP, Engelhardt P. Does Osgood-Schlatter disease modify the position of the patella? Z Orthop Inhre Brenzgeb 1984; 122:798–802

    Google Scholar 

  7. Aparicio G, Abril JC, Calvo E, Alvarez L. Radiographic study of patellar height in Osgood-Schlatter disease. J Pediatr Orthop 1997;17:63–66

    Article  CAS  PubMed  Google Scholar 

  8. Tria AJ JR, Alicea JA, Cody RP. Patella baja in anterior crutiate ligament reconstruction of the knee. Clin Orthop 1994; 299:229–234

    PubMed  Google Scholar 

  9. Noyes FR, Wojtys EM, Marshall MT. The early diagnosis and treatment of developmental patella infera syndrome. Clin Orthop 1991; 265:241–252

    PubMed  Google Scholar 

  10. Mann FA, Wilson AJ, Gilula LA. Radiographic evaluation of the wrist: What does the surgeon want to know? Radiology 1992; 184:15–24

    CAS  PubMed  Google Scholar 

  11. Sackett DL, Haynes RB, Tugwell P. Clinical epidemiology, a basic science for clinical medicine. Boston/Toronto: Little, Brown 1985: 51–55

  12. Boot-Itt SB. The normal position of the patella. AJR 1930; 24:389–394

    Google Scholar 

  13. Blumensaat C. Die lageabweichungen und verrenkungen der kniescheibe. Ergebn Chir Orthop 1938; 31:149–223

    Google Scholar 

  14. Blackburne JS, Peel TE. A new method of measuring patellar height. J Bone Joint Surg 1977; 59:241–242

    CAS  Google Scholar 

  15. de Carvalho A, Andersen AH, Topp S, Jurick AG. A method for assessing the height of the patella. Int Orthop 1985; 9:195–197

    PubMed  Google Scholar 

  16. Caton J, Deschamps G, Chambat P, Lerat JL, Dejour H. Les rotules basses-a propos de 128 observations. Riv Chir Orthop 1982; 68:317–325

    CAS  Google Scholar 

  17. Norman O, Egund N, Ekelund L, Runow A. The vertical position of the normal patella. Acta Orthop Scand 1983; 54:908–913

    CAS  PubMed  Google Scholar 

  18. Linclau L. Measuring patellar height. Acta Orthop Belg 1984; 50:70–74

    CAS  PubMed  Google Scholar 

  19. Ficat RP, Hungerford DS. Disorders of the patello-femoral joint. Baltimore: Williams and Wilkins, 1977

  20. Iwano T, Kurosawa H, Tokuyama H, et al. Roentgenographic and clinical findings of patellofemoral osteoarthritis. Clin Orthop 1990; 252:190

    PubMed  Google Scholar 

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Correspondence to Nogah Shabshin.

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Shabshin, N., Schweitzer, M.E., Morrison, W.B. et al. MRI criteria for patella alta and baja. Skeletal Radiol 33, 445–450 (2004). https://doi.org/10.1007/s00256-004-0794-6

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  • DOI: https://doi.org/10.1007/s00256-004-0794-6

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