Role of Computed Tomography in Diagnosis & Clarifying the Classification of Patello-femoral Malalignment
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he role of the conventional axial radiographs of the patellofemoral joint in assessing patients suffering from peripatellar pain is limited. Therefore Computed Tomography (CT) was used to evaluate 40 patients with persistent patello-femoral pain, and ten asymptomatic volunteers as a control group. Mid patellar transaxial cuts were taken for all of them at 0, 15, 30 and 45 degress of knee flexion. The congruence angle, the patellar tilt angle and the femoral trochlear angle were obtained front each image. According to the values of these three angles, patients were classified using Merchant's classification of patello-femoral malalignment into: Type 1 malalignment (patellar subluxation only - 12 cases). Type II malalignment (patellar subluxation and tilt - 10 cases). Type III malalignment (patellar tilt only - 13 cases). The CT has a significant advantage in diagnosing and identifying the different patterns of patello-femoral malalignment particularly when surgical realignment is planned. Anterior knee pain represents one of the most common musculuskeletal complaints, particularly among athletically motivated young adults('. It is the disorder which Diagnostic Radiology and 'Orthopedic Departments, Benha Faculty of Medicine, Zagazig University ***Diagnostic Radiology department, Faculty of Medicine, Cairo University. Vol. 36, No. I. .lanotary 2001 represent a difficult & frustrating entity for the patient to endure & for the physician to diagnose & treat(2.3) Routine radiographs are not consistently helpfull in the evaluation of patients with presumed malalignment syndrome") The capability of CT of producing midpatellar cross-sectional images at any position of knee flexion and without distortion suggests that the CT scan would also be ideal for studying the patellofemoral joint(5) Based on CT criteria of subluxation and tilt, it has become possible to categorize the patello-femoral tracking abnormalities(63). CT diagnosis of patello-femoral malalignment has a specificity of 95% and sensitivity of 85 %, and awareness of different patterns of malalignment is a significant advantage of CT when planning selective surgical realignment for these patients(5) This work aims to verify the role of Computed Tomography in diagnosis and clarifying classification system for patients with patello-femoral pain.