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Rofo 2021; 193(09): 1019-1033
DOI: 10.1055/a-1348-2122
Review

Diagnostic Imaging of Patellofemoral Instability

Article in several languages: English | deutsch
Kai-Jonathan Maas
1   Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
,
Malte Lennart Warncke
1   Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
,
Miriam Leiderer
1   Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
,
Matthias Krause
2   Department Trauma Surgery and Orthopedics, UKE, Hamburg, Germany
,
Tobias Dust
2   Department Trauma Surgery and Orthopedics, UKE, Hamburg, Germany
,
Jannik Frings
2   Department Trauma Surgery and Orthopedics, UKE, Hamburg, Germany
,
Karl-Heinz Frosch
2   Department Trauma Surgery and Orthopedics, UKE, Hamburg, Germany
,
Gerhard Adam
1   Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
,
Frank Oliver Gerhard Henes
1   Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Abstract

Background Throughout the literature, patellofemoral instability (PI) is defined as an increased risk of re-/luxation of the patella within the patellofemoral joint (PFJ). In most patients it is caused by traumatic patella luxation or the existence of a range of predisposing anatomic risk factors leading to an unphysiological movement sequence within the PFJ also known as patellofemoral maltracking. In order to provide an individualized therapy approach, clinical and radiological evaluation of those risk factors of variable magnitude becomes essential. Diagnostic imaging such as magnetic resonance imaging (MRI), plain radiography, and computed tomography (CT) are straightforward diagnostic tools in terms of evaluation and treatment of PI.

Method In this review we performed a precise analysis of today’s literature concerning the radiological evaluation of anatomic risk factors leading to PI. The purpose of the review is to present a logical compilation of the different anatomical risk factors causing PI and provide a straight overview of valuable radiological imaging techniques.

Results and Conclusion PI is frequently based on a multifactorial disposition. The most relevant predisposing risk factors are trochlea dysplasia, rupture of the medial patellofemoral ligament (MPFL), patella alta, abnormal tibial tubercle to trochlea groove distance (TT-TG), femoral torsion deformities, and genu valgum. Although plain X-rays may provide basic diagnostic value, cross-sectional imaging (MRI, CT) is the standard radiological tool in terms of evaluation and detection of severity of predisposing anatomic variants leading to PI.

Key Points: 

  • Based on today’s literature, PI is characterized as an increased risk of patella re-/luxation within the PFJ.

  • Underlying anatomic risk factors of variable magnitude mark the pathological cause of PI.

  • Modern diagnostic imaging (MRI and CT) permits straightforward diagnosis of the typical features in terms of PI.

  • To provide an individualized therapy approach, precise radiological evaluation and determination of the severity of predisposing anatomic anomalies are essential.

Citation Format

  • Maas KJ, Warncke ML, Leiderer M et al. Diagnostic Imaging of Patellofemoral Instability. Fortschr Röntgenstr 2021; 193: 1019 – 1033

Key words

patellofemoral joint - knee - patella - patellofemoral instability - maltracking - MRI


Publication History

Received: 15 September 2020

Accepted: 02 December 2020

Article published online:
27 March 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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