KMID : 0948920090080010013
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Clinical Pain 2009 Volume.8 No. 1 p.13 ~ p.19
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Diagnostic Usefulness of Pressure-assisted Patellofemoral Joint X-ray for Diagnosis of Chondromalacia of Patellofemoral Joint
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Im Kyung-Jin
Seo Jeong-Hwan Ko Myoung-Hwan Park Sung-Hee Lee Sang-Yong
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Abstract
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Objective: To diagnose the patellofemoral chondromalacia, physical examination is usually used. The cartilage of patella with chondromalacia are softer to pressure compared with the normal cartilage. The purpose of this study is to investigate the usefulness of a newly devised pressure-assisted knee X-ray method for the diagnosis of chondromalacia of the knee.
Materials and Methods: Twenty one patients with clinically diagnosed chondromalacia and 16 normal persons were enrolled. To apply the pressure to patellofemoral joint, 150 mmHg pressure was applied to the knee with manual blood pressure manometer. Before and after the application of the pressure, patella tangential view was taken and the distances between the femur and the patella were measured at the medial, the middle and the lateral part. Also, we evaluated the Q-angle, the coexistence of osteoarthritis, the duration of disease, Knee Society Score and 12-item Knee Score.
Results: In this study, the decrements of distance by compression were significant in the middle and the medial part of the patella in affected side of patients compared with the control group, especially the medial part. The discriminant analysis for the diagnosis of chondromalacia with this new X-ray method showed consistent results in 96% to positive predictive value and 97% to negative predictive value.
Conclusion: This new method of pressure-assisted knee X-ray was useful for the diagnosis of chondromalacia by measuring the distance between the patella and the femur. This method is thought to provide good diagnostic value with low cost, low invasive- ness and relatively good reliability.
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KEYWORD
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Chondromalacia patella, X-rays, Pressure, Knee, Patellofemoral pain syndrome
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