Learning objectives
To outline etiology, clinical presentation and commonest patellofemoral measures involved in diagnosis of excessive lateral pressure syndrome (ELPS)
To present different radiological imaging modalities.
To describe different possibilities of medical treatment and potential complications.
Background
Excessive lateral pressure syndrome is a common name for the clinical and radiological findings that describe cartilage loss of the lateral patellar facet and subsequent osteoarthritis, all due to excessive tightness of the lateral retinaculum. It is one of the frequent causes of the anterior knee pain with specific finding of the lateral patellar tilt without instability.
Findings and procedure details
1.Anatomy
Patella is the biggest sesamoid bone in the human body and a part of the knee joint.1,2It is triangular, with basis oriented cranialy, and apex oriented caudaly.1,2Patella has two sides: rugged ventral side, and smooth dorsal side. 1 On the dorsal side vertical stripe divides the smooth part of patella into two great articular zones, medial and lateral patellar facet.1 Superior third of the patellar ventral side is the site of insertion for quadriceps muscle tendon while the inferior third is the starting point...
Conclusion
Due to lack of information about ELPS in radiological literature it is crucial to start discussing specific sings and imaging possibilities. Using specific measurements during analisys of the CT scans and specific X-ray projections can speed up the process of diagnosing the ELPS. Those findings combined with MRI help anticipate and prevent patellar osteoarthritis.
Personal information and conflict of interest
V. Župančić; Nova Gradiška/HR - nothing to disclose R. Vukojević; Zagreb/HR - nothing to disclose D. Zadravec; Zagreb/HR - nothing to disclose
References
1-Cox CF, Hubbard JB. Anatomy, Bony Pelvis and Lower Limb, Knee Patella. [Updated 2018 Dec 6]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-.Available from: https://www.ncbi.nlm.nih.gov/books/NBK519534/
2-Loudon JK. Biomechanics and patomechanics f the patellofemoral joint.Int J Sports Phys Ther. 2016;11(6):820–830.
3-Fox AJ, Wanivenhaus F, Rodeo SA. The basic science of the patella: structure, composition, and function.J Knee Surg.2012 May;25(2):127-41
4-Fulkerson JP, Buuck DA, Dye SF, Farr J, Post WR– Disorders of the patellofemoral joint. 4th ed. Philadelphia: Lippincott Williams & Wilkins; 2004
5-Practical...