Ultrasonographic evaluation of patellar deviation and its influence on knee muscles and tendons Poster No.: C-0984 Congress: ECR 2015 Type: Authors: Keywords: DOI: Scientific Exhibit R. A. M. Santos, A. fidalgo, A. André; Coimbra/PT Musculoskeletal soft tissue, Ultrasound, Health policy and practice, Tissue characterisation 10.1594/ecr2015/C-0984 Any information contained in this pdf file is automatically generated from digital material submitted to EPOS by third parties in the form of scientific presentations. References to any names, marks, products, or services of third parties or hypertext links to thirdparty sites or information are provided solely as a convenience to you and do not in any way constitute or imply ECR's endorsement, sponsorship or recommendation of the third party, information, product or service. ECR is not responsible for the content of these pages and does not make any representations regarding the content or accuracy of material in this file. As per copyright regulations, any unauthorised use of the material or parts thereof as well as commercial reproduction or multiple distribution by any traditional or electronically based reproduction/publication method ist strictly prohibited. You agree to defend, indemnify, and hold ECR harmless from and against any and all claims, damages, costs, and expenses, including attorneys' fees, arising from or related to your use of these pages. Please note: Links to movies, ppt slideshows and any other multimedia files are not available in the pdf version of presentations. www.myesr.org Page 1 of 9
Aims and objectives The patellar deviation represents 2-3% of all knee injuries (1). Many risks associated like quadriceps muscle weakness, quadriceps and patellar tendons weakness, lower limb morphology (valgus and varus), overweight, aging, female gender and practice of sports (1,2). Ultrasound was the diagnostic method used due: Available Low cost Real time Well accepted No ionizing radiation (2). The aim of this study is to evaluate the influence of the quadriceps muscles and tendons thickness on patella deviation. As well as the influence of the o BMI, age, gender and sport on patella deviation. Methods and materials In this study, 61 subjects, aged 18-30 years (21 elite athletes and 40 sedentary) were submitted an ultrasound evaluation (linear probe 7-10 MHz). Determination of muscle region to be analyzed: The distance between the anterior superior iliac spine and the upper edge of the patella was measured and it was calculated 39% of this measure to find the muscle middle region. Ultrasound exam: Ultrasound images in transverse plane of the thigh muscles were acquired with the leg in extension. Also, ultrasound images in longitudinal plane of the quadriceps and patellar tendons were acquired (20 of knee flexion). Ultrasound images of the patella and femoral condyle were acquired to measure the distance between the femoral condyle and the patella (maximum flexion of the knee). Measurements: Page 2 of 9
The thigh muscles and the knee tendons (patellar and quadriceps tendons) thickness and their cross-section were measured, as well as the femoral condyle-patella distance were measured by Image J software. All relevant data were recorded and subsequently analyzed by SPSS software version 20.0. Images for this section: Fig. 1: Cross-section measurement of the muscle Page 3 of 9
Fig. 2: Cross-section measurement of the quadriceps tendon Page 4 of 9
Results There was a strong correlation among sports (R=80), the thigh muscles thickness (R=0.74), the knee tendons thickness (R=0.79) and their cross-section with the patella deviation (p>0.01). There was correlation between the patella deviation for the right and left knee, and also between gender and BMI (R=0.29) (p>0.01). There was no correlation among BMI, gender and the lower limbs morphology (p<0.01). There was no correlation between gender, sport and the patella deviation and the lower limb morphology (p<0.01). Images for this section: Page 5 of 9
Fig. 3: Right patellar deviation measurement Page 6 of 9
Fig. 4: Left patellar deviation measurement Page 7 of 9
Conclusion This results are in consonance with several studies that have shown that the individuals that practice sports as well as the sedentary individuals who have a quadriceps muscles and patellar tendons weakness present a patellar deviation predisposition (3,4,5). The decreasing the thickness of the vastus lateralis, vastus medialis and rectus femoris as well as the thickness of the patellar and quadriceps tendons increase the probability of the patellar deviation appearance. Personal information Santos, R., Fidalgo, A., André, A. Medical Imaging and Radiotherapy Department, Coimbra Health School, Polytechnic Institute of Coimbra, Portugal In case of any questions, comments or ideas feel free to contact the presenting author: rutesantos@estescoimbra.pt References 1. Earhart C., et al. Transient lateral patellar dislocation: review of imaging findings, patellofemoral anatomy, and treatment options. Emergency radiology [Internet]. 2013 Jan [cited 2013 Apr 12];20(1):11-23. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22941569 2. Monteiro P., Miguel E., Mola M. Ecografia Musculo-Esquelética em Reumatologia. 2009;388-94 3. Gibson, K., et al. Measurement of varus/valgus alignment in obese individuals with knee osteoarthritis. Arthritis care & research 2010 4. Herrington L., et al. Quantification of patella position by ultrasound scanning and its criterion validity. Ultrasound in medicine & biology [Internet]. 2006 Dec [cited 2013 Apr 12];32(12). Available from: http://www.ncbi.nlm.nih.gov/ pubmed/17169695 5. Oliveira, M., et al. Comparação da ativação muscular do vasto medial oblíquo e do vasto lateral durante o exercício de propriocepção no jump. Red de Revistas Científicas de América Latina, el Caribe, España y Portugal 2012 Page 8 of 9
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