Case Report: Quantitative MRI of Tibial Tubercle Transfer During Active Quadriceps Contraction.
Summary of "Case Report: Quantitative MRI of Tibial Tubercle Transfer During Active Quadriceps Contraction."
BACKGROUND:
The evaluation of distal transfer procedures relies primarily on qualitative clinical findings. Although quantitative MRI measurements provide an objective supplement to qualitative clinical findings, an association between qualitative clinical findings and quantitative patellofemoral indices has yet to be established. CASE
DESCRIPTION:
A 21-year-old man presented with frequent episodes of patellar dislocation. Clinical and radiographic findings identified the patient as a candidate for realignment. MR images were obtained with the quadriceps contracted at 30° flexion and in full extension preoperatively and postoperatively. The procedure eliminated the clinical J-sign, defined as lateral movement of the patella over the lateral femoral condyle during active leg extension, which was confirmed quantitatively using established patellofemoral indices in conjunction with MRI. LITERATURE
REVIEW:
Movement of the patellofemoral joint is complex and dependent on many factors, including skeletal geometry, dynamic muscle action, and soft tissue restraints. Therefore, proper clinical and radiographic evaluation of patellar tracking requires observation during active quadriceps contraction. However, it is unclear whether there is any association between quantitative radiographic indices and qualitative clinical assessment during active quadriceps contraction. PURPOSES AND CLINICAL
RELEVANCE:
We believe objective measurements are valuable in determining the radiographic assessment of patellar realignment procedures. Lateral patellar edge appears to quantify the clinical J-sign. The association between radiographic medialization of the patella and clinical improvement postoperatively in this patient warrants additional investigation in a larger group of patients with longer followup.
Affiliation
University of Iowa Carver College of Medicine, Iowa City, IA, USA.
Journal Details
This article was published in the following journal.
Name: Clinical orthopaedics and related research
ISSN: 1528-1132
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/20941650
- DOI: http://dx.doi.org/10.1007/s11999-010-1598-8
Medical and Biotech [MESH] Definitions
Quantitative Trait Loci
Locations, on the GENOME, of GENES or other genetic elements that encode or control the expression of a quantitative trait (QUANTITATIVE TRAIT, HERITABLE).
Fatal Outcome
Death resulting from the presence of a disease in an individual, as shown by a single case report or a limited number of patients. This should be differentiated from DEATH, the physiological cessation of life and from MORTALITY, an epidemiological or statistical concept.
Tibial Neuropathy
Disease of the TIBIAL NERVE (also referred to as the posterior tibial nerve). The most commonly associated condition is the TARSAL TUNNEL SYNDROME. However, LEG INJURIES; ISCHEMIA; and inflammatory conditions (e.g., COLLAGEN DISEASES) may also affect the nerve. Clinical features include PARALYSIS of plantar flexion, ankle inversion and toe flexion as well as loss of sensation over the sole of the foot. (From Joynt, Clinical Neurology, 1995, Ch51, p32)
Quantitative Trait, Heritable
A characteristic showing quantitative inheritance such as SKIN PIGMENTATION in humans. (From A Dictionary of Genetics, 4th ed)
Tibial Nerve
The medial terminal branch of the sciatic nerve. The tibial nerve fibers originate in lumbar and sacral spinal segments (L4 to S2). They supply motor and sensory innervation to parts of the calf and foot.
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