Herbert Chen MD, PRESENTER: Nothing to Disclose

Abstract: HTML Purpose: It has been noted in the literature that chronic anterior knee pain may be attributed to certain anatomic variations of patellofemoral anatomy as observed on plain film examinations. Our observations suggested that these published values may not be accurate. Our purpose was to reanalyze the accepted values using MR images of the knee and applying these measurements to include articular cartilage. Methods and Materials: Consecutive routine knee MR scans obtained on individuals under the age of 40 years old were reviewed. Analysis of these images included measurements of patellar trochlear angle, lateral patellofemoral angle, lateral patellar displacement angle, sulcus angle, congruence angle, trochlear depth, lateral trochlear inclination, patella to patellar ligament ratio, and the ratio of patella to patellar articular cartilage on axial and sagittal images. Individuals were divided into two groups: those without chronic anterior knee pain, and those with chronic anterior knee pain for a duration of at least six months and no associated traumatic etiology. Results: There were 82 patients without symptoms of anterior knee pain and 13 with symptoms of anterior knee pain. Measured values of those without anterior pain and those with anterior symptoms but no history of trauma within the preceding six months were as follows: Patellar trochlear angle 3 to 32 vs. 3 to 29, lateral patellofemoral angle 4 to 32 vs. 4 to 25, lateral patellar displacement angle 66 to 107 vs. 64 to 105, sulcus angle 134 to 161 vs. 131 to 155, congruence angle -12 to 16 vs. -12 to 15, trochlea r depth 2.0 to 8.7 vs. 2.8 to 6.3, lateral trochlear inclination 4 to 31 vs. 4 to 27, patellar ligament to patella ratio 0.63 to 1.63 vs. 0.74 to 1.65, and the ratio of patella to patellar articular cartilage 1.0 to 2.45 vs. 1.2 to 2.54. There was no sta tistical difference between the two groups. Conclusion: Our analysis shows no difference in perceived anatomic variation in patients without symptoms of chronic anterior knee pain and those with, based on measurements of cartilaginous surfaces with MRI as the standard.       Questions about this event email: lseeger@mednet.ucla.edu

Chen MD, H, MR Evaluation of the Patellofemoral Joint without and with Anterior Knee Pain.  Radiological Society of North America 2003 Scientific Assembly and Annual Meeting, November 30 - December 5, 2003 ,Chicago IL. http://archive.rsna.org/2003/3107201.html