Keywords:
Musculoskeletal system, Musculoskeletal joint, MR, PACS, Image compression, Developmental disease, Education and training
Authors:
L. Aghaghazvini, M. Tahmasebi, H. Sheidaee, S. Mirkarimi, M. Shakiba; Tehran/IR
DOI:
10.26044/ecr2019/C-3058
Aims and objectives
There are several theories about the multifactorial causes of patellofemoral pain syndrome (PFPS).
Malalignment in the lower extremity,
Abnormal patellar tracking quadriceps muscle weakness,
especially vastus medialis obliqus,
can be effective in creating PFPS through applying dynamic imbalance in knee extensor mechanism.
Unfortunately,
the underlying factors in the development of this disorder have not yet been well known [2].
Tibial tuberosity-trochlear groove distance (TT-TGD) measurements play a decisive role in evaluating patellofemoral joint disorders.
The increase in the distance indirectly indicates increase in lateral pull in the knee extensor mechanism [3].
The exact measurement of this parameter is possible through both CT scan and MRI.
However,
MRI is superior to CT scan in the examination of articular cartilage and soft tissue component [4].
The normal values defined for the TT-TGD vary considerably [3,5].
A TT-TGD of more than 20 mm in CT scan is considered pathological and tibial tuberosity osteotomy (TTO) has been suggested for these cases by some studies [5- 7].
It has been shown that the TT-TGD value is 3 to 4 mm less in MRI measurements than CT scan.
Hence,
TT-TGD values of more than 15 mm in MRI are suggested to be regarded as pathological [8,9].
Several studies have shown that TT-TGD has increased in patients with recurrent patellar dislocation without a history of trauma.
Accordingly,
in case of patellar instability,
TTO is performed routinely to correct the tibial tuberosity malposition.
(10-12) Although TTO has been proposed to relieve pain in patients with PFPS,
factors affecting the disease are not well known yet [13- 17].
The purpose of this study was to compare the size of TT-TGD among patients with PFPS and those with no history of patellofemoral pain.