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J Knee Surg 2017; 30(02): 143-151
DOI: 10.1055/s-0036-1583267
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

A Cadaveric Analysis of the Optimal Radiographic Angle for Evaluating Trochlear Depth

Douglas Stanley Weinberg
1   Rainbow Babies and Children's Hospital at Case Western Reserve University, Cleveland, Ohio
,
Allison Gilmore
1   Rainbow Babies and Children's Hospital at Case Western Reserve University, Cleveland, Ohio
,
Sahejmeet S. Guraya
1   Rainbow Babies and Children's Hospital at Case Western Reserve University, Cleveland, Ohio
,
David M. Wang
1   Rainbow Babies and Children's Hospital at Case Western Reserve University, Cleveland, Ohio
,
Raymond W. Liu
1   Rainbow Babies and Children's Hospital at Case Western Reserve University, Cleveland, Ohio
› Author Affiliations
Further Information

Publication History

31 December 2015

11 March 2016

Publication Date:
28 April 2016 (online)

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Abstract

Disorders of the patellofemoral joint are common. Diagnosis and management often involves the use tangential imaging of the patella and trochlear grove, with the sunrise projection being the most common. However, imaging protocols vary between institutions, and limited data exist to determine which radiographic projections provide optimal visualization of the trochlear groove at its deepest point. Plain radiographs of 48 cadaveric femora were taken at various beam–femur angles and the maximum trochlear depth was measured; a tilt-board apparatus was used to elevate the femur in 5-degree increments between 40 and 75 degrees. A corollary experiment was undertaken to investigate beam–femur angles osteologically: digital representations of each bone were created with a MicroScribe digitizer, and trochlear depth was measured on all specimens at beam–femur angles from 0 to 75 degrees. The results of the radiographic and digitizer experiments showed that the maximum trochlear grove depth occurred at a beam–femur angle of 50 degrees. These results suggest that the optimal beam–femur angle for visualizing maximum trochlear depth is 50 degrees. This is significantly lower than the beam–femur angle of 90 degrees typically used in the sunrise projection. Clinicians evaluating trochlear depth on sunrise projections may be underestimating maximal depth and evaluating a nonarticulating portion of the femur.

Keywords

patellofemoral joint - trochlear depth - sunrise - radiography - trochlear dysplasia
 

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