TITLE

Reliability of Clinical Findings and Magnetic Resonance Imaging for the Diagnosis of Chondromalacia Patellae

AUTHOR(S)
Pihlajamäki, Harri K.; Kuikka, Paavo-Ilari; Leppänen, Vesa-Veikko; Kiuru, Martti J.; Mattila, Ville M.
PUB. DATE
April 2010
SOURCE
Journal of Bone & Joint Surgery, American Volume;Apr2010, Vol. 92-A Issue 4, p927
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: This diagnostic study was performed to determine the correlation between anterior knee pain and chondromalacia patellae and to define the reliability of magnetic resonance imaging for the diagnosis of chondromalacia patellae. Methods: Fifty-six young adults (median age, 19.5 years) with anterior knee pain had magnetic resonance imaging of the knee followed by arthroscopy. The patellar chondral lesions identified by magnetic resonance imaging were compared with the arthroscopic findings. Results: Arthroscopy confirmed the presence of chondromalacia patellae in twenty-five (45%) of the fifty-six knees, a synovial plica in twenty-five knees, a meniscal tear in four knees, and a femorotibial chondral lesion in four knees; normal anatomy was seen in six knees. No association was found between the severity of the chondromalacia patellae seen at arthroscopy and the clinical symptoms of anterior knee pain syndrome (p = 0.83). The positive predictive value for the ability of 1.0-1 magnetic resonance imaging to detect chondromalacia patellae was 75% (95% confidence interval, 53% to 89%), the negative predictive value was 72% (95% confidence interval, 56% to 84%), the sensitivity was 60% (95% confidence interval, 41% to 77%), the specificity was 84% (95% confidence interval, 67% to 93%), and the diagnostic accuracy was 73% (95% confidence interval, 60% to 83%). The sensitivity was 13% (95% confidence interval, 2% to 49%) for grade-I lesions and 83% (95% confidence interval, 59% to 94%) for grade-Il, III, or IV lesions. Conclusions: Chondromalacia patellae cannot be diagnosed on the basis of symptoms or with current physical examination methods. The present study demonstrated no correlation between the severity of chondromalacia patellae and the clinical symptoms of anterior knee pain syndrome. Thus, symptoms of anterior knee pain syndrome should not be used as an indication for knee arthroscopy. The sensitivity of 1.0-1 magnetic resonance imaging was low for grade-I lesions but considerably higher for more severe (grade-Il, III, or IV) lesions. Magnetic resonance imaging may be considered an accurate diagnostic tool for identification of more severe cases of chondromalacia patellae.
ACCESSION #
49476019

 

Related Articles

  • Arthroscopy or MRI for knee injuries. Araujo, David // Physician & Sportsmedicine;Aug96, Vol. 24 Issue 8, p36q 

    Comments on the review article on the use of magnetic resonance imaging and arthroscopy to diagnose and treat painful knees by R. W. Jackson. Discussion of the advantages and disadvantages of the two procedures; Costs; Suggestion that treatment decisions should be left to the discretion of an...

  • MR imaging of displaced meniscal tears of the knee. Importance of a "disproportional posterior horn sign". Chen, H. C.; Hsu, C. Y.; Shih, T. T. F.; Huang, K. M.; Li, Y. W.; Shih, T T // Acta Radiologica;Jul2001, Vol. 42 Issue 4, p417 

    Purpose: Meniscal tears associated with displaced fragments are clinically significant. We propose the "disproportional posterior horn sign" as a supportive criterion to identify a posterocentrally displaced meniscal fragment on MR imaging studies. If the meniscal posterior horn in...

  • Assessment and management of post-traumatic haemarthrosis of the knee. Shaerf, Daniel; Banerjee, Ashis // British Journal of Hospital Medicine (17508460);Aug2008, Vol. 69 Issue 8, p459 

    The article provides direction for assessment and management of traumatic haemarthrosis of the knee in the acute phase. It discusses the advantages and disadvantages of two diagnostic strategy for traumatic haemarthrosis, the arthroscopic examination and magnetic resonance imaging. Moreover, it...

  • Successful repair of an isolated osteochondral fracture of the patella presenting with locking of the knee. Khan, Sk; Dowen, D; Asaad, Ss // Trauma;Jan2013, Vol. 15 Issue 1, p91 

    A 15-year-old boy presented with a locked knee after a football injury. Sudden valgus impact to the planted right leg caused a patellar osteochondral fracture diagnosed by magnetic resonance imaging. The 2.5-cm fragment had avulsed off the medial facet without damage to the medial retinaculum or...

  • Menisküs Ve BaÄŸ Yaralanmalarının Manyetik Rezonans Görüntüleme Ve Artroskopik Cerrahi Bulgularının KarşılaÅŸtırılması. ÖZTURAN, Kutay Engin; YÜCEL, İstemi; ÇAKICI, Hüsamettin; GÜVEN, Melih; GÜREL, Kamil // Duzce Medical Journal;2012, Vol. 14 Issue 2, p1 

    Purpose: Magnetic resonance imaging is frequently used in the diagnosis of the meniscal and ligamentous injuries. The aim of this study is to compare the results of the knee arthroscopy and magnetic resonance imaging findings retrospectively. Methods: Of the sixty-two patients 37 (59.7%) were...

  • Why in the world. Gordon, David George // Current Science;12/18/98, Vol. 84 Issue 8, p15 

    Reports on a study done by radiologist Martin Schwartz which revealed that magnetic resonance imaging (MRI) often reveal what seem to be signs of knee injuries in children even though the joints are healthy. Mechanism of MRI; Theory for the appearance of images showing damage on healthy knees.

  • Reduce MRI use for knee injuries.  // Physician & Sportsmedicine;Apr96, Vol. 24 Issue 4, p16 

    Presents information on the overuse of magnetic resonance imaging (MRI), in the determination of knee disorders. Information on `Magnetic resonance imaging of knee disorders: clinical value and cost-effectiveness in a sports medicine practice' article by H.J. Gelb, S.G. Glasgow and A.A. Sapega...

  • Objective patellar instability: MR-based quantitative assessment of potentially associated anatomical features. Escala, Joan; Mellado, José; Olona, Montserrat; Giné, Josep; Saurí, Amadeu; Neyret, Phillipe; Escala, Joan S; Mellado, José M; Giné, Josep; Saurí, Amadeu // Knee Surgery, Sports Traumatology, Arthroscopy;Mar2006, Vol. 14 Issue 3, p264 

    To evaluate and compare the diagnostic utility of multiple quantitative parameters as measured on knee magnetic resonance (MR) examinations of patients suffering objective patellar instability (OPI). We performed a retrospective evaluation of knee MR examinations in a group of 46 patients (59...

  • Effect of Specialty and Experience on the Interpretation of Knee MRI Scans. Kim, Allis; Khoury, Lisa; Schweitzer, Mark; Jazrawi, Laith; Ishak, Charbel; Meislin, Robert; Kummer, Fred; Sherman, Orrin H. // Bulletin of the NYU Hospital for Joint Diseases;2008, Vol. 66 Issue 4, p272 

    The purpose of this study was to evaluate any differences in the accuracy of knee MRI interpretation between radiology and orthopaedic surgery residents as well as to evaluate differences in quality of interpretation relative to resident training level. In this study, 20 MRI scans demonstrating...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics