MRI performed on dedicated knee coils is inaccurate for the measurement of tibial tubercle trochlear groove distance

Aarvold, Alexander; Pope, Alvan; Sakthivel, V.; Ayer, Ravi

doi:10.1007/s00256-013-1790-5

Cited by 25 publications

(38 citation statements)

References 18 publications

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“…37 For instance, TTTG values were acquired at various flexion and extension degrees of the knee; however, it was shown that the TTTG distance increases significantly in the end-stage extension of the knee. 37,40,41 The mean TTTG values on MR images were 15.1 AE 3.2 mm at full extension, 10.0 AE 3.5 mm at 15 degrees flexion, and 8.1 AE 3.4 mm at 30 degrees flexion in a well-balanced study cohort of asymptomatic volunteers. 37 Using the MR body coil with the knee fully extended caused significantly higher TTTG values compared with MR examinations with a dedicated knee coil where the knee is slightly flexed.…”

Section: Tuberosity To the Trochlear Groove Distancementioning

confidence: 84%

“…37 Using the MR body coil with the knee fully extended caused significantly higher TTTG values compared with MR examinations with a dedicated knee coil where the knee is slightly flexed. 41 In addition, the dedicated knee coil often causes a slight varus alignment of the lower limb, which also explains in part the lower TTTG distances. 39 As a consequence, the comparability of reported TTTG distance values obtained on radiographs, CT, and MRI at various flexion angles and varus alignment of the knee is limited.…”

Section: Tuberosity To the Trochlear Groove Distancementioning

confidence: 99%

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Imaging of Individual Anatomical Risk Factors for Patellar Instability

Dietrich

Fucentese

Pfirrmann

2016

Semin Musculoskelet Radiol

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This review article presents several pitfalls and limitations of image interpretation of anatomical risk factors for patellar instability. The most important imaging examinations for the work-up of patients with patellar instability are the true lateral radiograph and transverse computed tomography (CT) or MR images of the knee. Primary anatomical risk factors are an insufficient medial patellofemoral ligament (MPFL), patella alta, trochlear dysplasia, increased distance from the tibial tuberosity to the trochlear groove (TTTG), and torsional limb parameters. Limitations of the Caton-Deschamps index are related to the clear identification of the patellar and tibial articular margin. Classification of trochlear dysplasia according to the Dejour system on radiographs and MR images revealed a weak reliability. The comparability of TTTG values obtained on CT and MR images at various flexion angles and different varus alignments of the knee is limited. Thus MRI performed with a dedicated knee coil may underestimate the TTTG distance compared with CT images. Increased lateral patellar tilt is a consequence of primary anatomical risk factors rather than an independent anatomical risk factor for patellar instability. The pretest likelihood of a torn MPFL on MR images is very high after an acute episode of lateral patellar dislocation. Surgical restoration of the patellofemoral joint stability addresses the complex multifactorial biomechanics by a custom-made management such as MPFL reconstruction, sulcus-deepening trochleoplasty, as well as medialization and distalization of the tibial tubercle. Quantification of anatomical risk factors for patellar instability in each person is important for highly individual treatment.

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Section: Tuberosity To the Trochlear Groove Distancementioning

confidence: 84%

Section: Tuberosity To the Trochlear Groove Distancementioning

confidence: 99%

Imaging of Individual Anatomical Risk Factors for Patellar Instability

Dietrich

Fucentese

Pfirrmann

2016

Semin Musculoskelet Radiol

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“…7,16 Decreased tibial external rotation for MRI scans likely contributes to up to 4 mm smaller TT-TG distance values noted for MRI scans than CT scans. [6][7][8][9] Knee coils used for MRI scans induce knee flexion, 6,17 thereby reducing tibial external rotation associated with terminal knee extension. 18 MRI knee coils also induce $5 degrees of knee varus, further decreasing TT-TG distance.…”

Section: Discussionmentioning

confidence: 99%

Variations in Tibial Tuberosity to Trochlear Groove and Posterior Cruciate Ligament Distances due to Tibial External and Valgus Rotations

et al. 2017

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Tibial rotations with respect to the femur influence measurements used to assess the lateral position of the tibial tuberosity. This study utilized computational modeling to quantify how the tibial tuberosity to trochlear groove (TT-TG) and tibial tuberosity to posterior cruciate ligament attachment (TT-PCL) distances vary with tibial internal/external and varus/valgus rotations. Computational models were developed from magnetic resonance imaging data to represent eight knees with patellar instability. TT-TG and TT-PCL distances were quantified from the computational models for a neutral orientation and with the tibia rotated internally and externally and into varus and valgus in 1-degree increments to 5 degrees. Regression analyses related tibial rotations to TT-TG and TT-PCL distances. TT-TG distance increased with tibial external rotation, and both TT-TG and TT-PCL distances increased with valgus orientation ( > 0.94 for all regressions). The average increase in TT-TG distance for each 1 degree of tibial external rotation was 0.55 mm (range: 0.50-0.62 mm), compared with 0.00 mm (range: -0.05 to 0.04 mm) for TT-PCL distance. The average increase in TT-TG distance for each 1 degree of valgus was 1.01 mm (range: 0.91-1.14 mm), compared with 0.46 mm (range: 0.32-0.60 mm) for TT-PCL distance. TT-TG distance varies more with tibial rotations than TT-PCL distance due to both points being on the tibia and a smaller proximal-distal distance between the points for TT-PCL distance.

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“…However, there are some clinical factors that may affect the reliability of these measurement parameters, such as the knee flexion angle and quadriceps action [9–13]. In clinical practice, the knee is usually flexed to some degree due to the MRI coil shape, the knee position in the coil, and differences in operator habits [12]. Between conventional MRI scans, it is hard to set a uniform examination position of the knee even for the same individual.…”

Section: Introductionmentioning

confidence: 99%

Patellar instability: the reliability of magnetic resonance imaging measurement parameters

et al. 2019

BMC Musculoskelet Disord

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Background Radiological assessments are considered an important part of the management of patellar instability (PI). However, PI measurements are influenced by the knee position, which cannot be guaranteed to be the same for each examination. Therefore, we aimed to determine the reliability of common PI measurements on magnetic resonance imaging (MRI). Methods Two MRI examinations within a 6-month period were obtained from 51 knees. The common PI measurements were quantitatively determined and re-evaluated. The intraclass correlation coefficients (ICC), Bland–Altman plot, standard error of measurement (SEM), and minimal detectable change (MDC) were used to determine the intra-observer, inter-observer, and inter-scan reliability. Results Adequate intra- and inter-observer reliability was obtained for all PI measurements (all ICCs > 0.8). For patellar positional parameters, the inter-scan reliability was adequate for the angle of Fulkerson, angle of Laurin, patellar tilt angle (PTA), lateral patellar displacement (LPD), and bisect offset ratio (BSO; ICCs = 0.723–0.897), although it was inadequate for the angle of Grelsamer and the congruence angle (CA; ICCs = 0.325–0.380). All parameters of trochlear dysplasia showed adequate inter-scan reliability (ICCs = 0.793–0.915). Nearly all patellar height parameters showed adequate inter-scan reliability (ICCs = 0.700–0.903), except the patellar trochlear index (PTI; ICC = 0.655). Conclusion All PI measurements showed adequate intra- and inter-observer reliability on MRI. Most measurements showed adequate inter-scan reliability, with the exception of the angle of Grelsamer, CA, and PTI. Electronic supplementary material The online version of this article (10.1186/s12891-019-2697-7) contains supplementary material, which is available to authorized users.

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MRI performed on dedicated knee coils is inaccurate for the measurement of tibial tubercle trochlear groove distance

Cited by 25 publications

References 18 publications

Imaging of Individual Anatomical Risk Factors for Patellar Instability

Imaging of Individual Anatomical Risk Factors for Patellar Instability

Variations in Tibial Tuberosity to Trochlear Groove and Posterior Cruciate Ligament Distances due to Tibial External and Valgus Rotations

Patellar instability: the reliability of magnetic resonance imaging measurement parameters

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