Cross-sectional imaging of the patellofemoral joint and surrounding structures

Computed tomography (CT) and magnetic resonance (MR) imaging are extremely useful in the accurate diagnosis of anterior knee pain, a common complaint arising from numerous causes (including fracture, chondromalacia patellae, and alignment and tracking abnormalities). Plain CT is effective for evaluating intraosseous lesions of the knee. Although CT arthrography provides excellent visualization of the patellar articular cartilage, the technique is expensive and invasive. Cine CT is an excellent method for assessing patellofemoral tracking and alignment. Kinematic MR imaging can also perform this function. In addition, MR imaging can provide valuable information concerning the status of patellar cartilage. Although MR imaging can accurately show high-grade chondromalacia patellae, it is less accurate in the detection of low-grade disease. The authors believe that MR imaging and plain radiography offer radiologists the greatest latitude in making a specific diagnosis of the cause of anterior knee pain; however, CT is a useful alternative.