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. |
