Vastus lateralis fibrosis in habitual patella dislocation: an MRI study in 28 patients

We studied 28 patients with habitual or recurrent dislocation of the patella with MRI of both thighs. Apart from the 2 patients whose dislocation could be related to trauma, we found signs of fibrosis of the vastus lateralis muscle in all the affected limbs of the 26 patients with an insidious onset of dislocation. This was seen as low signal intensity cords in the muscles in the T2 weighted image. Muscle degeneration was seen as high intensity signals in the T1 weighted image. In patients with unilateral disease, the vastus lateralis muscle of the affected side was hypotrophic, compared to that of the normal side. 2 patients underwent a biopsy of the affected muscle area. Histopathological examination revealed inflammatory cell infiltration, fibrosis, and muscle fiber degeneration. Fibrosis of the vastus lateralis muscle appears to be common in patients with habitual patella dislocation in our population, and may be the cause of the dislocation. Since release of such a contracture may be of value, MRI study of the thigh muscles is helpful in the evaluation of patients with this disorder.