The Role of the Ultrasonographic Knee Assessment in the Diagnosis of Patellofemoral Pain Syndrome

  • Shila Haghighat Department of Physical Medicine and Rehabilitation, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
  • Mehdi Karami Department of Imaging and Radiology, Isfahan University of Medical Sciences, Isfahan, Iran
  • Nasim Ghasemi Department of Physical Medicine and Rehabilitation, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
  • Babak Vahdatpour Department of Physical Medicine and Rehabilitation, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran https://orcid.org/0000-0002-3325-0538
  • Samira Soleimany Department of Imaging and Radiology, Isfahan University of Medical Sciences, Isfahan, Iran
Keywords: Patellofemoral Pain Syndrome, Sulcus, Q Angle, Ultrasonography

Abstract

Background: Patellofemoral Pain Syndrome (PFPS) is a common anterior knee compartment pain etiology. It has been aimed to assess the ultrasonographic findings of the patellofemoral joint in patients with PFPS versus healthy individuals. Materials and Methods: The current case-control investigation was performed on 30 cases suffering from patellofemoral joint pain and 30 healthy individuals in Isfahan during 2020-21. All cases underwent ultrasonography to assess cartilage thickness, sulcus angle, and sulcus depth. We also measured the Q angle with a manual goniometer. Results: In healthy individuals, Q angle scores were statistically lower than in the cases group (P=0.002). The sulcus angle was remarkably higher among the patients compared to the controls. The cartilage thickness (P=0.88) and sulcus depth (P=0.543) scores had no statistical difference between the PFPS and healthy subjects (P<0.05). Conclusions: Patients with PFPS had significantly higher Q angle and lower sulcus angle than the healthy controls.

References

Gaitonde DY, Ericksen A, Robbins RC. Patellofemoral Pain Syndrome. Am Fam Physician. 2019;99(2):88-94.

Alba-Martín P, Gallego-Izquierdo T, Plaza-Manzano G, Romero-Franco N, Núñez-Nagy S, Pecos-Martín D. Effectiveness of therapeutic physical exercise in the treatment of patellofemoral pain syndrome: a systematic review. J Phys Ther Sci. 2015;27(7):2387-90.

https://doi.org/10.1589/jpts.27.2387

PMid:26311988 PMCid:PMC4540887

Gulati A, McElrath C, Wadhwa V, Shah JP, Chhabra A. Current clinical, radiological and treatment perspectives of patellofemoral pain syndrome. Br J Radiol. 2018;91(1086):20170456.

https://doi.org/10.1259/bjr.20170456

PMid:29303366 PMCid:PMC6223269

Collins NJ, Barton CJ, Van Middelkoop M, Callaghan MJ, Rathleff MS, Vicenzino BT, et al. 2018 Consensus statement on exercise therapy and physical interventions (orthoses, taping and manual therapy) to treat patellofemoral pain: recommendations from the 5th International Patellofemoral Pain Research Retreat, Gold Coast, Australia, 2017. Br J Sports Med. 2018;52(18):1170-8.

https://doi.org/10.1136/bjsports-2018-099397

PMid:29925502

Rothermich MA, Glaviano NR, Li J, Hart JM. Patellofemoral pain: epidemiology, pathophysiology, and treatment options. Clin Sports Med. 2015;34(2):313-27.

https://doi.org/10.1016/j.csm.2014.12.011

PMid:25818716

Smith BE, Selfe J, Thacker D, Hendrick P, Bateman M, Moffatt F, et al. Incidence and prevalence of patellofemoral pain: A systematic review and meta-analysis. PLoS One. 2018;13(1):e0190892.

https://doi.org/10.1371/journal.pone.0190892

PMid:29324820 PMCid:PMC5764329

Glaviano NR, Kew M, Hart JM, Saliba S. Demographic and epidemiological trends in patellofemoral pain. Int J Sports Phys Ther. 2015;10(3):281-90.

Tramontano M, Pagnotta S, Lunghi C, Manzo C, Manzo F, Consolo S, Manzo V. Assessment and Management of Somatic Dysfunctions in Patients With Patellofemoral Pain Syndrome. J Am Osteopath Assoc. 2020;120(3):165-73.

https://doi.org/10.7556/jaoa.2020.029

PMid:32091560

Cui LH. Research progress on the etiology and treatment of patellofemoral pain syndrome. Zhongguo Gu Shang. 2017;30(7):680-4.

Van Der Heijden RA, Lankhorst NE, Van Linschoten R, Bierma-Zeinstra SM, Van Middelkoop M. Exercise for treating patellofemoral pain syndrome. Cochrane Database Syst Rev. 2015;1:CD010387.

https://doi.org/10.1002/14651858.CD010387.pub2

PMCid:PMC6457759

Ghany JF, Kamel S, Zoga A, Farrell T, Morrison W, Belair J, Desai V. Extensor mechanism tendinopathy in patients with lateral patellar maltracking. Skeletal Radiol. 2021;50(11):2205-12.

https://doi.org/10.1007/s00256-021-03787-8

PMid:33876276

Crossley KM, Callaghan MJ, Van Linschoten R. Patellofemoral pain. BMJ. 2015;351:h3939.

https://doi.org/10.1136/bmj.h3939

PMid:26537829

Drew BT, Redmond AC, Smith TO, Penny F, Conaghan PG. Which patellofemoral joint imaging features are associated with patellofemoral pain? Systematic review and meta-analysis. Osteoarthritis Cartilage. 2016;24(2):224-36.

https://doi.org/10.1016/j.joca.2015.09.004

PMid:26471209

Van Der Heijden RA, De Kanter JL, Bierma-Zeinstra SM, Verhaar JA, Van Veldhoven PL, Krestin GP, et al. Structural Abnormalities on Magnetic Resonance Imaging in Patients With Patellofemoral Pain: A Cross-sectional Case-Control Study. Am J Sports Med. 2016;44(9):2339-46.

https://doi.org/10.1177/0363546516646107

PMid:27206691

Van Middelkoop M, Macri EM, Eijkenboom JF, Van Der Heijden RA, Crossley KM, Bierma-Zeinstra SMA, et al. Are Patellofemoral Joint Alignment and Shape Associated With Structural Magnetic Resonance Imaging Abnormalities and Symptoms Among People With Patellofemoral Pain? Am J Sports Med. 2018;46(13):3217-26.

https://doi.org/10.1177/0363546518801314

PMid:30321064 PMCid:PMC6236631

Drew BT, Conaghan PG, Smith TO, Selfe J, Hensor EMA, Dube B, et al. Toward the Development of Data-Driven Diagnostic Subgroups for People With Patellofemoral Pain Using Modifiable Clinical, Biomechanical, and Imaging Features. J Orthop Sports Phys Ther. 2019;49(7):536-47.

https://doi.org/10.2519/jospt.2019.8607

PMid:31213159

Fanlo-Mazas P, Bueno-Gracia E, De Escudero-Zapico AR, Tricás-Moreno JM, Lucha-López MO. The Effect of Diacutaneous Fibrolysis on Patellar Position Measured Using Ultrasound Scanning in Patients With Patellofemoral Pain Syndrome. J Sport Rehabil. 2019;28(6):564-9.

https://doi.org/10.1123/jsr.2017-0272

PMid:29651911

Romero-Morales C, Bravo-Aguilar M, Ruiz-Ruiz B, Almazán-Polo J, López-López D, Blanco-Morales M, et al. Current advances and research in ultrasound imaging to the assessment and management of musculoskeletal disorders. Dis Mon. 2021;67(3):101050.

https://doi.org/10.1016/j.disamonth.2020.101050

PMid:32711897

Jeon H, Donovan L, Thomas AC. Exercise-Induced Changes in Femoral Cartilage Thickness in Patients with Patellofemoral Pain. J Athl Train (in press). 2022.

https://doi.org/10.4085/1062-6050-0602.21

PMid:35476136

Brushøj C, Hölmich P, Nielsen MB, Albrecht-Beste E. Acute patellofemoral pain: aggravating activities, clinical examination, MRI and ultrasound findings. Br J Sports Med. 2008;42(1):64-7.

https://doi.org/10.1136/bjsm.2006.034215

PMid:17562742

Lin YF, Lin JJ, Cheng CK, Lin DH, Jan MH. Association between sonographic morphology of vastus medialis obliquus and patellar alignment in patients with patellofemoral pain syndrome. J Orthop Sports Phys Ther. 2008;38(4):196-202.

https://doi.org/10.2519/jospt.2008.2568

PMid:18434663

Payne K, Payne J, Larkin TA. Patellofemoral Pain Syndrome and Pain Severity Is Associated With Asymmetry of Gluteus Medius Muscle Activation Measured Via Ultrasound. Am J Phys Med Rehabil. 2020;99(7):595-601.

https://doi.org/10.1097/PHM.0000000000001367

PMid:31860586

Schoots EJ, Tak IJ, Veenstra BJ, Krebbers YM, Bax JG. Ultrasound characteristics of the lateral retinaculum in 10 patients with patellofemoral pain syndrome compared to healthy controls. J Bodyw Mov Ther. 2013;17(4):523-9.

https://doi.org/10.1016/j.jbmt.2013.03.005

PMid:24139014

Fischhoff C. Patellofemoral pain syndrome: ultrasound measurements for diagnosis. Int Musculoskelet Med. 2015;37(2):54-8.

https://doi.org/10.1179/1753614615Z.000000000100

Published
2022-12-25
How to Cite
Haghighat, S., Karami, M., Ghasemi , N., Vahdatpour, B., & Soleimany , S. (2022). The Role of the Ultrasonographic Knee Assessment in the Diagnosis of Patellofemoral Pain Syndrome. Galen Medical Journal, 11, e2420. https://doi.org/10.31661/gmj.v11i.2420
Section
Original Article