The role of the conventional ax-ial radiographs of the patello-femoral joint in assessing pa-tients suffering from peripatellar pain is limited. Therefore Computed Tomo-graphy (CT) was used to evaluate 40 patients with persistent patello-femor-al pain, and ten asymptomatic volun-teers 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 from each image. According to the values of these three angles, patients were clas-sified using Merchant's classification of patello-femoral malalignment into: Type I malalignment (patellar subluxation only - 12 cases). , Type II malalignment (patellar sub-luxation and tilt - 10 cases). Type III malalignment (patellar tilt only - 13 cases). The CT has a significant advantage in diagnosing and identifying the dif-ferent patterns of patello-femoral ma-lalignment 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, mummy 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 mid-patellar cross-sectional images at any posi-tion of knee flexion and without distortion suggests that the CT scan would also be ideal for studying tile patell_ofemoral joint(5) Based on CT criteria of subluxation and tilt, it has become possible to categorize the patello-femoral tracking abnormalities(6:7). CT diagnosis of patello-femoral mala-lign.ment 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.
Subjects & Methods This current study was performed on 40 patients, attending to the orthopedic clinic at Benha University Hospital. Ten asymp-tomatic volunteers as a control group were included. The patients were 28 females and 12 males with average age 18 years ranging. from 14 to 42 years and they were com-plaining of peri-patellar ,.pain or anterior knee pain which is aggravated with stair
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