Aktuelle Traumatol 2006; 36(4): 180-182
DOI: 10.1055/s-2006-924589
Varia

Georg Thieme Verlag KG Stuttgart · New York

Ultrasonography: A Highly Efficient Modality for Anterior Knee Pain Diagnosis

Ultrasonographie: Eine sehr effiziente Methode zur Diagnostik anteriorer KnieschmerzenI. Dudkiewicz1 , A. Blankstein2
  • 1Department of Orthopedic Rehabilitation, Sheba Medical Center, Tel-Hashomer, Israel
  • 2Department of Orthopedic Surgery, Sheba Medical Center, Tel-Hashomer, Israel
Further Information

Publication History

Publication Date:
20 September 2006 (online)

Zusammenfassung

250 Kniegelenke bei 125 konsekutiven Patienten wurden im Ultraschall zur Diagnostik anteriorer Knieschmerzen untersucht. Durchschnittsalter war 22,2 Jahre (15 - 30 Jahre). Die durchschnittliche Untersuchungsdauer betrug 6,5 min (5 - 11 min). Krankhafte Veränderungen wurden in 57 von 125 beschwerdegebenden Kniegelenken gefunden: 7-mal infrapatellare Bursitis, 6-mal suprapatellare Bursitis, 38-mal Patellarsehnen-Tendinitis (17 suprapatellar, 9 infrapatellar, 12 supra- und infrapatellar), 1 Ganglionzyste, 1 Patellafraktur, 2 Verkalkungen in der Patellarsehne, 1 Patella bipartita und 1 Weichteiltumor. Die Autoren empfehlen die Ultraschalluntersuchung als Methode der ersten Wahl in der Diagnostik des anterioren Knieschmerzes.

Abstract

Purpose: To assess the usefulness of ultrasound in diagnosing pathologies in cases of anterior knee pain. The efficiency of US (ultrasound) usage as a diagnostic tool in the knee was proven in previous reports, even in comparison to MRI (Magnetic Resonance Imaging), especially in the superficial area. We represent here our experience in ultrasound usage as diagnostic tool for anterior knee pain in young adults. Material and Methods: 250 knees of 125 consecutive patients had ultra-sonogram during one year due to diagnosis of anterior knee pain. The mean patients' age was 22.22 ± 4.62 years, ranging from 15 to 30 years. The mean examination time was 6.5 ± 1.55 minutes, ranging from 5 to 11 minutes. Results: Pathological findings were found in 57 out of 125 symptomatic knees. Seven patients with infrapatellar bursitis, 6 with suprapatellar bursitis, 17 with proximal patellar tendonitis, 9 with distal patellar tendonitis, 12 with pan patellar tendonitis, 1 with ganglion cyst, 1 patella fracture, 2 cases of calcification in the patellar tendon, 1 with patella bipartite and 1 case had a soft tissue mass. Conclusions: As in many other soft tissue lesions in the musculoskeletal system, ultrasonography is a very useful and effective tool in evaluation of pathologies and diagnosis for anterior knee pain. We suggest that US should be the imaging procedure of choice to diagnose pathologies of the anterior knee. Due to the accuracy for soft tissue diagnosis around the knee, the short time of the examination, the low cost, the safety (lack of radiation), and the availability, we highly recommend the use of ultrasound for soft tissue diagnosis around the knee and as a first line diagnostic tool for anterior knee pain.

References

  • 1 Biedert R M, Sanchis-Alfonso V. Sources of anterior knee pain.  Clin Sports Med. 2002;  21 335-347, vii
  • 2 Blankstein A, Cohen I, Salai M, Diamant L, Chechick A, Ganel A. Ultrasonography: an imaging modality enabling the diagnosis of bipartite patella.  Knee Surg Sports Traumatol Arthrosc. 2001;  9 221-224
  • 3 Cook J L, Khan K M, Kiss Z S, Griffiths L. Patellar tendinopathy in junior basketball players: a controlled clinical and ultrasonographic study of 268 patellar tendons in players aged 14 - 18 years.  Scand J Med Sci Sports. 2000;  10 216-220
  • 4 Cook J L, Khan K M, Harcourt P R, Kiss Z S, Fehrmann M W, Griffiths L, Wark J D. Patellar tendon ultrasonography in asymptomatic active athletes reveals hypoechoic regions: a study of 320 tendons. Victorian Institute of Sport Tendon Study Group.  Clin J Sport Med. 1998;  8 73-77
  • 5 Davies S G, Baudouin C J, King J B, Perry J D. Ultrasound, computed tomography and magnetic resonance imaging in patellar tendinitis.  Clin Radiol. 1991;  43 52-56
  • 6 Duffey M J, Martin D F, Cannon D W, Craven T, Messier S P. Etiologic factors associated with anterior knee pain in distance runners.  Med Sci Sports Exerc. 2000;  32 1825-1832
  • 7 Duri Z A, Aichroth P M, Wilkins R, Jones J. Patellar tendonitis and anterior knee pain.  Am J Knee Surg. 1999;  12 99-108
  • 8 Grobbelaar N, Bouffard J A. Sonography of the knee, a pictorial review.  Semin Ultrasound CT MR. 2000;  21 231-274
  • 9 Khan K M, Bonar F, Desmond P M, Cook J L, Young D A. et al . Patellar tendonitis (jumper's knee): findings at histopathologic examination, US, and MR imaging. Victorian Institute of Sport Tendon Study Group.  Radiology. 1996;  200 821-827
  • 10 King J B, Perry D J, Mourad K, Kumar S J. Lesions of the patellar ligament.  J Bone Joint Surg [Br]. 1990;  72 46-48
  • 11 Laine H R, Harjula A, Peltokallio P. Ultrasound in the evaluation of the knee and patellar regions.  J Ultrasound Med. 1987;  6 33-36
  • 12 Miller T T, Shapiro M A, Schultz E, Crider R, Paley D. Sonography of patellar abnormalities in children.  AJR Am J Roentgenol. 1998;  171 739-742
  • 13 Teitz C C. Ultrasonography in the knee. Clinical aspects.  Radiol Clin North Am. 1988;  26 55-62

M.D. Alexander Blankstein

Department of Orthopedic Surgery and Diagnostic Imaging
The Chaim Sheba Medical Center

Tel Hashomer 52621

Israel

Fax: + 9 72/3/5 49-42 69

Email: blankali@zahav.net.il

    >