Learning objectives
To demonstrate the usefulness of dynamic US study with muscle contraction,
and typical radiological findings in patellar instability and patellofemoral pain syndrome.
To perform a standardizedprocedureof ultrasound examination in patients with Patellofemoral pain syndrome (PFPS).
Background
Patellofemoral pain syndrome (PFPS) is a frequent disease,
especially in young patients.
The cause of this syndrome has been linked to an abnormal lateral tracking of the patella and instability factors such as patellar trochlear dysplasia or patella Alta,
leading to joint incongruence and overload that causes cartilage deterioration and femoropatellar osteoarthritis.Therefore,
early diagnosis is essential,
though it remains difficult as it is based primarily on the clinical presentation and the exclusion of other pathologies.
The radiological techniques used for the diagnosis of this pathology...
Findings and procedure details
Ultrasound is a method that allows the study of the peripatellar soft tissues and part of the trochlear groove,
in particular,
its hyaline cartilage and its relationship with the patellar tip.
Technique of study:
Patient lying in dorsal decubitus position,
with extension of both knees and feet in external rotation at 15 °,
with the US transducer placed axially on the thickest portion of the patellar tendon,
progressing cephalad until finding the tip of the patella (acousticshadow) that allows us to assess its position in...
Conclusion
The US of the knee allows the dynamic assessment of the femoropatellar joint and does not use radiation.
It can be a complementary study in patients with symptoms of patellar instability.
The incorporation of study protocols with qualitative criteria(trochlear dysplasia and hyaline cartilage thickness)andquantitative criteria(trochlear cartilage angle and PTTG distance) is considered of utmost importance.
Personal information
Dr.
Maria Florencia Salum
Resident in training.
Department of Radiology,
Instituto Oulton,
Velez Sarsfield 562,
CP: 5000,
Córdoba,
Argentina.
Email:
[email protected]
Dr.
Manuel Albarenque
Department of Osteoarticular Radiology,
Instituto Oulton,
Velez Sarsfield 562,
CP: 5000,
Córdoba,
Argentina.
Email:
[email protected]
Department of Osteoarticular Radiology,
Instituto Oulton:
Dr.
M.
Albarenque
Dr.
F.
Foa Torres
Dr.
G.
Martinez
Residents in training:
Dr.
M.
Quevedo
Dr.
M.
F.
Salum
References
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Walch G,
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Rev Chir Orthop Reparatrice Appar Mot.
1990;76 (1): 45-54.
2.Toms A,
Cahir J,
Swift L,
Donell S.
Imaging the femoral sulcus with ultrasound,
CT,
and MRI: reliability and generalizability in patients with patellar instability.
Skeletal Radiology.
2009;38(4):329-338.
3. Fischhoff C.
Patellofemoral pain syndrome: Ultrasound measurements for diagnosis.
International Musculoskeletal Medicine.
2015;37(2):54-58.
4. Martino F,
De Serio A,
Macarini L,
Rizzo A,
Laforgia R,
Rotondo A et al.
Ultrasonography versus computed tomography in evaluation...