Vibration arthrography as a diagnostic aid in diseases of the knee. A preliminary report

Abstract

The detection and recording of vibration emission from human joints, a technique which we have termed "vibration arthrography", is a sensitive, non-invasive method for the objective study of the locomotor system. Using vibration sensors attached to bony prominences around the knee, we studied the joints of both normal and symptomatic subjects. Normal subjects produced three signal types-physiological patellofemoral crepitus, patellar clicks, and the lateral band signal. In symptomatic subjects we indentifled and categorised many signal types and related them to pathology. Lesions of the menisci produced distinctive signals, and it was possible not only to lateralise the tear, but in many cases to determine the type of meniscal injury present. Vibration arthrography promises to be a useful tool in the non-invasive diagnosis of knee disorders.

People's beliefs about the meaning of crepitus in patellofemoral pain and the impact of these beliefs on their behaviour: A qualitative study

“…Several causes of crepitus have been described [3][4] [5], but previous research has focused on the pathological meaning of crepitus. No research has demonstrated a definitive link between noise and pathology, and McCoy et al, (1987) [6] demonstrate that 99 percent of a cohort of subjects with no pain had patellofemoral crepitus. Overall its importance and meaning is unclear.…”

Compartment‐directed physical examination of the knee can predict articular cartilage abnormalities disclosed by needle arthroscopy

“…Although therapies that might modify OA cartilage are still experimental or in development (25), reproducible means of assessing cartilage non-invasively would be useful in clinical tests of such agents. Small accelerometers (microphones) can record and quantitate crepitus, and could be used to enhance the precision of the examiner's hand (26). Whether investigators conducting field studies of OA might benefit from compartment-directed crepitus as assessment tools remains to be determined.…”

Cavitation in Other Non-Newtonian Biological Fluids

“…Some sounds are produced by patellofemoral crepitus (a fine crunching noise, usually on bending the knee from standing, which is said to be due the kneecap cartilage rubbing against the underlying cartilage of the femur) or when the plica (a thin wall of fibrous tissue that are extensions of the synovial capsule of the knee) snaps over the end of the femur (Beverland et al 1986;McCoy et al 1987). Other studies provide clear evidence that the anatomic source of the cracking sound associated with spinal high-velocity low-amplitude thrust manipulations is associated with cavitation of the synovial fluid (Watson and Mollan 1990;Evans 2002).…”