Role of magnetic resonance imaging evaluation of anterior knee pain

Background: the term "anterior knee pain" is often used interchangeably with "Patellofemoral pain syndrome PFPS" or "runner's knee". PFPS can be defined as anterior knee pain involving the patella and retinaculum

Aim of the Work: to highlight the role of magnetic resonance imaging [MRI] in the diagnosis and grading of the most common causes of anterior knee pain

Patients and Methods: this study included fifty patients, their ages range between 10-60 years [average age 27 years]. All presented with anterior knee pain [AKP] and were referred to the Radiology Department of El-Demerdash Hospital for MRI examination after orthopedic consultation

Results: the role of MRI in the diagnosis and grading of the most common causes of anterior knee pain have been shown in this study. These causes have been classified in to five disease categories; Patellar abnormalities represented most of them [64% of the sample size] and they included chondromalacia patella, patellar instability, transient patellar dislocation and painful bipartite patella. Hoffa's diseases represented 12% of the sample size and they included Hoffa impingement syndrome and Hoffa fibrotic bands. Patellar tendon disorders represented 6 % of the sample size and they included Patellar Tendinopathy and Osgood Schlatter Disease. Quadriceps tendon disorders represented 4% of the sample size and they included Quadriceps Tendinopathy. Other causes represented 14% of the sample size and they included torn anterior horn of the lateral meniscus and cartilage injuries

Conclusion: many factors may cause anterior knee pain. MRI is generally safe, non-ionizing, non-invasive and valuable imaging technique which has been proven to be the modality of choice for establishing an accurate diagnosis of different knee pathologies that cause anterior knee pain in different age groups. It also allows to know the extent, severity, grades and types of the lesions, what will be necessary to decide appropriate treatment

Recommendations: further studies on a larger scale of patients are needed to confirm the results obtained by this work

Patellofemoral pain syndromealters joint position sense: a case-control study / A síndrome da dor patelofemoral altera a sensação de posição articular: estudo caso-controle

Introduction: The evaluation of changes in joint position sense (JPS) of the knee may be crucial for the identification of disorders that could start during the development of patellofemoral pain syndrome (PFPS). Objective: To evaluate JPS of the knee in PFPS. Methods: Twenty nine women (15 healthy and 14 with PFPS) reproduced knee flexion angles of 45° and 60° during open kinetic chain exercises and of 45° during closed kinetic chain exercises. Results: The absolute error in the active reproduction of 45° in open kinetic chain exercises was significantly higher in the experimental group. There were significant differences in absolute and relative errors between the groups for active reproduction at 45° in open and closed kinetic chain exercises. Conclusions: This study suggests that PFPS alters JPS during active reproduction of the 45° angle in both open and closed kinetic chain exercises.

Resumo Introdução: A avaliação de alterações do senso de posição articular (SPA) do joelho é crucial para a identificação de desordens que ocorrem durante o desenvolvimento da síndrome da dor patelofemoral (SDPF). Objetivo: Avaliar o SPA do joelho na SDPF. Métodos: Vinte e nove mulheres (15 saudáveis e 14 com SDPF) reproduziram os ângulos de 45° e 60° de flexão do joelho em cadeia cinética aber - ta e de 45° em cadeia cinética fechada. Resultados: O erro absoluto na reprodução ativa do ângulo de 45° em cadeia cinética aberta foi significativamente maior no grupo experimental. Foi observada diferença significante entre os grupos nos erros relativo e absoluto para a reprodução ativa do ângulo de 45° em cadeia cinética aberta e fechada. Conclusões: Este estudo sugere que a SDPF altera a SPA durante reprodução ativa do ângulo de 45°, tanto em cadeia cinética aberta quanto em fechada.

Efeito de diferentes calçados no ínicio da atividade eletromiográfica dos músculos estabilizadores da patela / Effect of different shoes at the onset electromyographic activity of patellar stabilizer muscles

Introdução: A síndrome da dor femoropatelar (SDFP) é caracterizada por uma dor difusa na região retopatelar. A SDFP tem maior prevalência em mulheres jovens e sua etiologia não é totalmente conhecida. Objetivo: O objetivo desse trabalho foi comparar a porcentagem de disparo inicial (PDI) dos músculos vasto medial oblíquo (VMO) e vasto lateral longo (VLL) de mulheres saudáveis com disfunção femoropatelar (SDFP) ao sentar e levantar de um banco, calçando sapatos de salto alto, tênis e descalças. Métodos: Vinte mulheres foram divididas em dois grupos: controle e SDFP. O início da atividade EMG dos músculos VMO e VLL foi registrada durante a realização das tarefas, executadas com diferentes calçados. Para a comparação das PDIs foi utilizado o teste Qui-quadrado com p<0,05. Resultados: Verificou-se que o uso do tênis e do salto alto proporcionaram aumento da PDI no grupo controle. No entanto, nenhuma diferença foi observada no grupo SDFP. Conclusão: Os resultados sugerem que os indivíduos com SDFP não apresentam respostas adaptativas ao uso de diferentes calçados.

Introduction: Patellofemoral pain syndrome (PPS) is characterized by diffuse pain in the retropatellar region. The PPS has a higher prevalence in young women and its aetiology is not fully understood. Objective: The aim of this study was to compare the percentage of onset (%) of the vastus medialis oblique (VMO) and vastus lateralis longus (VLL) of healthy women and with patellofemoral pain syndrome (PPS) during sitting and standing tasks, wearing hig heeled shoes, tennis shoes and barefoot. Methods: Twenty women were divided into two groups: control group and PPS. The onset of EMG activity of VMO and VLL muscles was recorded during the tasks, using different shoes. To compare the percentage of onset was used chi-square test with p <0.05. Results: It was found that the use of high-heeled and tennis shoes promote increased the PDI in the control group. However, no difference was observed in the PPS group. Conclusion: The results suggest that individuals with PPS do not present adaptive responses to the use of different shoes.