Abstract
Objective
To determine the patterns of patellar motion in subjects without knee symptoms using dynamic magnetic resonance imaging (MRI).
Design
Patellar tracking MR examinations were performed on 50 asymptomatic volunteers. The presence and degree of lateral subluxation and tilt of the patella was assessed independently by three radiologists, and discrepancies resolved by consensus. Using the same criteria, the tracking pattern in 50 consecutive patients, recently referred for imaging assessment of anterior knee pain, was studied.
Patients
Fifty volunteers (22 male, mean age 37 years) and 50 unmatched patients (15 male, mean age 25.5 years) were examined.
Results and conclusions
Forty-one per cent of a total of 97 knees in the volunteer group showed evidence of lateral subluxation, which was either minimal (grade 1, 32%) or minor (grade 2, 9%). No volunteer demonstrated major (grade 3) subluxation; lateral tilt without translation of the patella was also seen (2%). In the patient group, higher grades of lateral subluxation were more common. Minimal (grade 1) lateralization is a common movement pattern of the patella on knee extension, and should be regarded as normal.
Similar content being viewed by others
References
Sanchis-Alfonso V, Rosello-Sastre E, Martinez-Sanjuan V. Pathogenesis of anterior knee pain syndrome and functional patellofemoral instability in the active young. Am J Knee Surg 1999; 12:29–40.
Eckhoff D, Montgomery W, Kilcoyne R, Stamm E. Femoral morphometry and anterior knee pain. Clin Orthop 1994; 302:64–68.
Reikeras O. Patellofemoral characteristics in patients with increased femoral anteversion. Skeletal Radiol 1992; 21:311–313.
Dejour H, Walch G, Nove-Josserand L, Guier C. Factors of patellar instability: an anatomic radiographic study. Knee Surg Sports Traumatol Arthrosc 1994; 2:19–26.
Muneta T, Yamamoto H, Ishibashi T, Asahina S, Furuya K. Computerized tomographic analysis of tibial tubercle position in the painful female patellofemoral joint. Am J Sports Med 1994; 22:67–71.
Ficat P, Ficat C, Bailleux A. Syndrome d’hyperpression externe de la rotule (SHPE). Son interet pour la connaissance de l’arthrose. Rev Chir Orthop 1975; 61:39–59.
Seedholm B, Takeda T, Tsubuku M, Wright V. Mechanical factors and patellofemoral osteoarthrosis. Ann Rheum Dis 1979; 38:307–316.
Oberlander M, Baker C, Morgan B. Patellofemoral arthrosis: treatment options. Am J Orthop 1998; 27:263–270.
Aglietti P, Buzzi R, De Biase P, Giron F. Surgical treatment of recurrent dislocation of the patella. Clin Orthop 1994; 308:8-17.
McNally E, Ostlere S, Pal C, Phillips A, Reid H, Dodd C. Assessment of patellar maltracking using combined static and dynamic MRI. Eur Radiol 2000; 10:1051–1055.
Stanford W, Phelan J, Kathol M, et al. Patellofemoral joint motion: evaluation by ultrafast computed tomography. Skeletal Radiol 1988; 17:487–492.
Fulkerson J. The etiology of patellofemoral pain in the young, active patients: a prospective study. Clin Orthop 1983; 179:129–133.
McNally E. Imaging assessment of anterior knee pain and patellar maltracking. Skeletal Radiol 2001; 30:484–495.
Dye S, Vaupel G. The pathophysiology of patellofemoral pain. Sports Med Arthrosc Rev 1994; 2:203–210.
Kannus P, Natri A, Paakkala T, Jarvinen M. An outcome study of chronic patellofemoral pain syndrome. J Bone Joint Surg Am 1999; 81:355–363.
Tria A, Palumbo R, Alicea J. Conservative care for patellofemoral pain. Orthop Clin North Am 1992; 23:545–554.
Nagamine R, Miura H, Inoue Y, et al. Malposition of the tibial tubercle during flexion in knees with patellofemoral arthritis. Skeletal Radiol 1997; 26:597–601.
Remy F, Chantelot C, Fontaine C, Demondion X, Migaud H, Gougeon F. Inter- and intraobserver reproducibility in radiographic diagnosis and classification of femoral trochlear dysplasia. Surg Radiol Anat 1998; 20:285–289.
Beaconsfield T, Pintore E, Maffulli N, Petri G. Radiological measurements in patellofemoral disorders. Clin Orthop 1994; 308:18–28.
Murray T, Dupont JY, Fulkerson J. Axial and lateral radiographs in evaluating patellofemoral malalignment. Am J Sports Med 1999; 27:580–584.
Daenen B, Ferrara M, Marcelis S, Dondelinger R. Evaluation of patellar cartilage surface lesions: comparison of CT-arthrography and fat-suppressed FLASH 3D MR imaging. Eur Radiol 1998; 8:981–985.
Gagliardi J, Chung E, Chandnani V, et al. Detection and staging of chondromalacia patellae: relative efficacies of conventional MR imaging, MR arthrography and CT arthrography. AJR Am J Roentgenol 1994; 163:629–636.
Brown S, Bradley W. Kinematic magnetic resonance imaging of the knee. MRI Clin North Am 1994; 2:441–449.
Shea K, Fulkerson J. Preoperative computed tomography scanning and arthroscopy in predicting outcome after lateral retinacular release. Arthroscopy 1992; 8:327–334.
Hughston J, Walsh W, Puddu G. Chondromalacia and other extensor mechanism disorders. In: Patellar subluxation and dislocation. Philadelphia: WB Saunders, 1984:155–186.
Ficat R, Hungerford D. Patellofemoral arthrosis. In: Disorders of the patellofemoral joint. Baltimore: Williams and Wilkins, 1977:183–193.
Fulkerson J, Tennant R, Jaivin J, Grunnet M. Histologic evidence of retinacular nerve injury associated with patellofemoral malalignment. Clin Orthop 1985; 197:196–205.
Muhle C, Brossmann J, Heller M. Kinematic CT and MR imaging of the patellofemoral joint. Eur Radiol 1999; 9:508–518.
Biedert R, Gruhl C. Axial computed tomography of the patellofemoral joint with and without quadriceps contraction. Arch Orthop Trauma Surg 1997; 116:77–82.
Walker C, Cassar-Pullicino V, Vaisha R, McCall I. The patellofemoral joint: a critical appraisal of its geometric assessment utilizing conventional axial radiography and computed arthro-tomography. Br J Radiol 1993; 66:755–761.
Bergmann A, Fredericson M. MR imaging of stress reactions, muscle injuries and other overuse injuries in runners. MRI Clin North Am 1999; 7:151–174.
Shellock F, Mink J, Deutsch A, Foo K, Sullenberger P. Patellofemoral joint: identification of abnormalities with active movement, “unloaded” versus “loaded” kinematic MR imaging techniques. Radiology 1993; 188:575–578.
Brossmann J, Muhle C, Schroder C, et al. Patellar tracking patterns during active and passive knee extension: evaluation with motion-triggered cine MR imaging. Radiology 1993; 187:205–212.
Schutzer S, Ramsby G, Fulkerson J. The evaluation on patellofemoral pain using computerized tomography. Clin Orthop 1986; 204:286–293.
Brossmann J, Muhle C, Bull C, et al. Evaluation of patellar tracking in patients with suspected malalignment: cine MR imaging vs. arthroscopy. AJR Am J Roentgenol 1994; 162:361–367.
Delgado-Martins H. A study of the position of the patella using computerised tomography. J Bone Joint Surg Br 1979; 61:443–444.
Martinez M, Korobkin M, Fondren F, Hedlund L, Goldner J. Computed tomography of the normal patellofemoral joint. Invest Radiol 1983; 18:249–253.
Kujala U, Osterman K, Kormarno M, Komu M, Schlenzka D. Patellar motion analyzed by magnetic resonance imaging. Acta Orthop Scand 1989; 60:13–16.
Shellock F, Mink J, Deutsch A, Fox J. Patellar tracking abnormalities: clinical experience with kinematic MR imaging in 130 patients. Radiology 1989; 172:799–804.
Shellock F, Foo T, Deutsch A, Mink J. Patellofemoral joint: evaluation during active flexion with ultrafast spoiled GRASS MR imaging. Radiology 1991; 180:581–585.
Shellock F, Mink J, Fox J. Patellofemoral joint: kinematic MR imaging to assess tracking abnormalities. Radiology 1988; 168:551–553.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
O’Donnell, P., Johnstone, C., Watson, M. et al. Evaluation of patellar tracking in symptomatic and asymptomatic individuals by magnetic resonance imaging. Skeletal Radiol 34, 130–135 (2005). https://doi.org/10.1007/s00256-004-0867-6
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00256-004-0867-6