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Axial and lateral radiographs in evaluating patellofemoral malalignment
T F Murray1, J Y Dupont, J P Fulkerson
1University of Connecticut School of Medicine, Farmington, USA.
The American Journal of Sports Medicine
|September 25, 1999
Summary
The lateral knee X-ray view is highly sensitive for detecting prior patellar dislocation. Combined with axial views, these imaging techniques can confirm patellofemoral malalignment.
Area of Science:
- Orthopedic imaging
- Radiology
- Biomechanics
Background:
- Patellofemoral pain and instability are common orthopedic conditions.
- Accurate diagnosis of patellar dislocation and malalignment is crucial for effective treatment.
Purpose of the Study:
- To evaluate the diagnostic accuracy of specific radiographic views in detecting patellar subluxation and dislocation.
- To compare the sensitivity and specificity of axial and lateral views in assessing patellofemoral abnormalities.
Main Methods:
- Prospective study of 431 patients with knee abnormalities and 217 asymptomatic controls.
- Radiographic assessment included anteroposterior, axial (30° flexion), and standing lateral (0° and 30° flexion) views.
- Evaluation of patellar tilt and subluxation on axial and lateral views.
Main Results:
- The lateral view demonstrated 98% sensitivity for prior patellar dislocation, compared to 62% for the axial view.
- Specificity for previous dislocation was 93% for the lateral flexed view and 82% for the axial view.
- Abnormalities were detected in 35% of control knees on the extended lateral view versus 18% on the axial view.
Conclusions:
- The lateral view is highly sensitive for identifying prior patellar dislocation, making a normal result indicative of no prior event.
- Combined axial and lateral views offer high specificity for confirming patellofemoral malalignment.
- These radiographic views are valuable tools in the diagnosis of patellofemoral joint abnormalities.