Patellofemoral friction syndrome

Magnetic resonance imaging correlation of morphologic and T2 cartilage imaging

Ty Subhawong, Rashmi S. Thakkar, Abraham Padua, Aaron Flammang, Avneesh Chhabra, John A. Carrino

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

OBJECTIVE: This study aimed to investigate whether patellofemoral T2 cartilage changes are associated with lateral patellofemoral friction syndrome (PFS), as indicated by an edema-like signal within the superolateral infrapatellar (Hoffa) fat pad. METHODS: In this institutional review board-approved retrospective study of 510 consecutive patients, 49 patients with 50 knee magnetic resonance imaging examinations demonstrating normal or low-grade patellofemoral cartilage abnormalities (whole-organ magnetic resonance imaging score [WORMS] score, ≤2) were included. Twenty-two examinations with PFS (cases) were compared with an age- and sex-matched cohort of 28 examinations without PFS (controls). A 3-T magnetic resonance imaging was performed with multi-echo, spin-echo T2 mapping. Two readers measured in consensus malalignment parameters, including patellar height index, tibial tuberosity to trochlear groove distance, and sulcus angle. Bulk T2 cartilage values in the lateral and medial patellofemoral compartment, central weight-bearing medial and lateral femoral condyles were measured independently. Interobserver agreement was quantified using concordance correlation coefficients. Demographics, anatomic measurements, whole-organ magnetic resonance imaging scores, and cartilage T2 values were compared between cases and controls using Fisher exact test, Wilcoxon rank sum test, and mixed-effects models. RESULTS: Cases demonstrated higher patellar height index (P = 0.002) and tibial tuberosity to trochlear groove distance (P = 0.02). Interobserver agreement for T2 values was good overall (concordance correlation coefficient range, 0.65-0.93). Cases demonstrated higher medial facet patellar bulk T2 (38.1 [7.5] ms) versus controls (33.6 [7.3] ms) (P = 0.02); otherwise, there were no significant differences in regional T2 values. CONCLUSIONS: T2 mapping in patients with PFS demonstrates increased cartilage T2 in the medial patellar facet, possibly reflecting collagen alteration from early chondromalacia (softening) or increased water content related to altered contact pressures.

Original languageEnglish
Pages (from-to)308-312
Number of pages5
JournalJournal of Computer Assisted Tomography
Volume38
Issue number2
DOIs
StatePublished - Jan 1 2014

Fingerprint

Patellofemoral Pain Syndrome
Friction
Cartilage
Magnetic Resonance Imaging
Nonparametric Statistics
Cartilage Diseases
Research Ethics Committees
Weight-Bearing
Thigh
Adipose Tissue
Edema
Knee
Collagen
Retrospective Studies
Demography
Pressure
Bone and Bones
Water

Keywords

  • Cartilage
  • Patellar malalignment
  • Patellofemoral friction syndrome
  • T2 mapping

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Patellofemoral friction syndrome : Magnetic resonance imaging correlation of morphologic and T2 cartilage imaging. / Subhawong, Ty; Thakkar, Rashmi S.; Padua, Abraham; Flammang, Aaron; Chhabra, Avneesh; Carrino, John A.

In: Journal of Computer Assisted Tomography, Vol. 38, No. 2, 01.01.2014, p. 308-312.

Research output: Contribution to journalArticle

Subhawong, Ty ; Thakkar, Rashmi S. ; Padua, Abraham ; Flammang, Aaron ; Chhabra, Avneesh ; Carrino, John A. / Patellofemoral friction syndrome : Magnetic resonance imaging correlation of morphologic and T2 cartilage imaging. In: Journal of Computer Assisted Tomography. 2014 ; Vol. 38, No. 2. pp. 308-312.
@article{cd6bf84ab5b749f0a7a394df962e51c3,
title = "Patellofemoral friction syndrome: Magnetic resonance imaging correlation of morphologic and T2 cartilage imaging",
abstract = "OBJECTIVE: This study aimed to investigate whether patellofemoral T2 cartilage changes are associated with lateral patellofemoral friction syndrome (PFS), as indicated by an edema-like signal within the superolateral infrapatellar (Hoffa) fat pad. METHODS: In this institutional review board-approved retrospective study of 510 consecutive patients, 49 patients with 50 knee magnetic resonance imaging examinations demonstrating normal or low-grade patellofemoral cartilage abnormalities (whole-organ magnetic resonance imaging score [WORMS] score, ≤2) were included. Twenty-two examinations with PFS (cases) were compared with an age- and sex-matched cohort of 28 examinations without PFS (controls). A 3-T magnetic resonance imaging was performed with multi-echo, spin-echo T2 mapping. Two readers measured in consensus malalignment parameters, including patellar height index, tibial tuberosity to trochlear groove distance, and sulcus angle. Bulk T2 cartilage values in the lateral and medial patellofemoral compartment, central weight-bearing medial and lateral femoral condyles were measured independently. Interobserver agreement was quantified using concordance correlation coefficients. Demographics, anatomic measurements, whole-organ magnetic resonance imaging scores, and cartilage T2 values were compared between cases and controls using Fisher exact test, Wilcoxon rank sum test, and mixed-effects models. RESULTS: Cases demonstrated higher patellar height index (P = 0.002) and tibial tuberosity to trochlear groove distance (P = 0.02). Interobserver agreement for T2 values was good overall (concordance correlation coefficient range, 0.65-0.93). Cases demonstrated higher medial facet patellar bulk T2 (38.1 [7.5] ms) versus controls (33.6 [7.3] ms) (P = 0.02); otherwise, there were no significant differences in regional T2 values. CONCLUSIONS: T2 mapping in patients with PFS demonstrates increased cartilage T2 in the medial patellar facet, possibly reflecting collagen alteration from early chondromalacia (softening) or increased water content related to altered contact pressures.",
keywords = "Cartilage, Patellar malalignment, Patellofemoral friction syndrome, T2 mapping",
author = "Ty Subhawong and Thakkar, {Rashmi S.} and Abraham Padua and Aaron Flammang and Avneesh Chhabra and Carrino, {John A.}",
year = "2014",
month = "1",
day = "1",
doi = "10.1097/RCT.0b013e3182aab187",
language = "English",
volume = "38",
pages = "308--312",
journal = "Journal of Computer Assisted Tomography",
issn = "0363-8715",
publisher = "Lippincott Williams and Wilkins",
number = "2",

}

TY - JOUR

T1 - Patellofemoral friction syndrome

T2 - Magnetic resonance imaging correlation of morphologic and T2 cartilage imaging

AU - Subhawong, Ty

AU - Thakkar, Rashmi S.

AU - Padua, Abraham

AU - Flammang, Aaron

AU - Chhabra, Avneesh

AU - Carrino, John A.

PY - 2014/1/1

Y1 - 2014/1/1

N2 - OBJECTIVE: This study aimed to investigate whether patellofemoral T2 cartilage changes are associated with lateral patellofemoral friction syndrome (PFS), as indicated by an edema-like signal within the superolateral infrapatellar (Hoffa) fat pad. METHODS: In this institutional review board-approved retrospective study of 510 consecutive patients, 49 patients with 50 knee magnetic resonance imaging examinations demonstrating normal or low-grade patellofemoral cartilage abnormalities (whole-organ magnetic resonance imaging score [WORMS] score, ≤2) were included. Twenty-two examinations with PFS (cases) were compared with an age- and sex-matched cohort of 28 examinations without PFS (controls). A 3-T magnetic resonance imaging was performed with multi-echo, spin-echo T2 mapping. Two readers measured in consensus malalignment parameters, including patellar height index, tibial tuberosity to trochlear groove distance, and sulcus angle. Bulk T2 cartilage values in the lateral and medial patellofemoral compartment, central weight-bearing medial and lateral femoral condyles were measured independently. Interobserver agreement was quantified using concordance correlation coefficients. Demographics, anatomic measurements, whole-organ magnetic resonance imaging scores, and cartilage T2 values were compared between cases and controls using Fisher exact test, Wilcoxon rank sum test, and mixed-effects models. RESULTS: Cases demonstrated higher patellar height index (P = 0.002) and tibial tuberosity to trochlear groove distance (P = 0.02). Interobserver agreement for T2 values was good overall (concordance correlation coefficient range, 0.65-0.93). Cases demonstrated higher medial facet patellar bulk T2 (38.1 [7.5] ms) versus controls (33.6 [7.3] ms) (P = 0.02); otherwise, there were no significant differences in regional T2 values. CONCLUSIONS: T2 mapping in patients with PFS demonstrates increased cartilage T2 in the medial patellar facet, possibly reflecting collagen alteration from early chondromalacia (softening) or increased water content related to altered contact pressures.

AB - OBJECTIVE: This study aimed to investigate whether patellofemoral T2 cartilage changes are associated with lateral patellofemoral friction syndrome (PFS), as indicated by an edema-like signal within the superolateral infrapatellar (Hoffa) fat pad. METHODS: In this institutional review board-approved retrospective study of 510 consecutive patients, 49 patients with 50 knee magnetic resonance imaging examinations demonstrating normal or low-grade patellofemoral cartilage abnormalities (whole-organ magnetic resonance imaging score [WORMS] score, ≤2) were included. Twenty-two examinations with PFS (cases) were compared with an age- and sex-matched cohort of 28 examinations without PFS (controls). A 3-T magnetic resonance imaging was performed with multi-echo, spin-echo T2 mapping. Two readers measured in consensus malalignment parameters, including patellar height index, tibial tuberosity to trochlear groove distance, and sulcus angle. Bulk T2 cartilage values in the lateral and medial patellofemoral compartment, central weight-bearing medial and lateral femoral condyles were measured independently. Interobserver agreement was quantified using concordance correlation coefficients. Demographics, anatomic measurements, whole-organ magnetic resonance imaging scores, and cartilage T2 values were compared between cases and controls using Fisher exact test, Wilcoxon rank sum test, and mixed-effects models. RESULTS: Cases demonstrated higher patellar height index (P = 0.002) and tibial tuberosity to trochlear groove distance (P = 0.02). Interobserver agreement for T2 values was good overall (concordance correlation coefficient range, 0.65-0.93). Cases demonstrated higher medial facet patellar bulk T2 (38.1 [7.5] ms) versus controls (33.6 [7.3] ms) (P = 0.02); otherwise, there were no significant differences in regional T2 values. CONCLUSIONS: T2 mapping in patients with PFS demonstrates increased cartilage T2 in the medial patellar facet, possibly reflecting collagen alteration from early chondromalacia (softening) or increased water content related to altered contact pressures.

KW - Cartilage

KW - Patellar malalignment

KW - Patellofemoral friction syndrome

KW - T2 mapping

UR - http://www.scopus.com/inward/record.url?scp=84897105819&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84897105819&partnerID=8YFLogxK

U2 - 10.1097/RCT.0b013e3182aab187

DO - 10.1097/RCT.0b013e3182aab187

M3 - Article

VL - 38

SP - 308

EP - 312

JO - Journal of Computer Assisted Tomography

JF - Journal of Computer Assisted Tomography

SN - 0363-8715

IS - 2

ER -