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Axial MRI index of patellar engagement: a new method to assess patellar instability.
[trochlear dysplasia]
The
aim
of
this
study
was
to
define
a
new
index
to
measure
lateral
patellar
displacement
(
LPD
)
using
nuclear
magnetic
resonance
imaging
(
MRI
)
,
an
axial
index
of
engagement
of
the
patella
(
AEI
)
obtained
from
two
different
axial
MRI
views
then
to
validate
its
use
in
a
prospective
series
of
patients
presenting
an
objective
patellar
instability
(
OPI
)
.
One
hundred
and
thirty-
five
patients
with
OPI
and
no
history
of
surgery
of
the
patella
were
included
in
a
prospective
study
organized
by
the
French
Society
of
Arthroscopy
performed
between
June
2010
and
August
2012
.
All
patients
underwent
axial
and
sagittal
MRI
.
The
AEI
was
obtained
by
projecting
predefined
patellar
and
trochlear
landmarks
(
cartilaginous
landmarks
)
on
2
different
axial
MRI
views
(
one
trochlear
and
one
patellar
)
.
The
results
were
compared
with
a
series
of
controls
(
n
=
45
)
.
The
preoperative
AEI
of
the
patella
was
0
.
94
±
0
.
09
for
the
control
group
and
0
.
84
±
0
.
16
for
OPI
group
(
P
=
0
.
000016
)
.
The
AEI
could
be
obtained
in
100
%
of
the
cases
if
it
was
measured
on
2
MRI
views
while
it
could
not
be
measured
in
38
.
5
%
of
the
cases
if
the
measurement
was
only
obtained
from
one
MRI
view
or
whenever
the
widest
part
of
the
patella
was
not
across
from
the
femoral
trochlea
.
The
AEI
did
not
significantly
depend
on
dysplasia
or
the
presence
of
a
supratrochlear
spur
.
The
lowest
AIE
values
were
associated
with
trochlear
dysplasia
with
a
supratrochlear
spur
(
P
=
0
.
0023
)
and
a
more
prominent
trochlea
(
P
=
0
.
0016
)
.
The
AEI
was
correlated
with
patellar
tilt
(
P
<
0
.
000001
)
and
TT-
TG
on
MRI
(
P
<
0
.
000001
)
.
AEI
is
a
new
index
to
measure
LPD
.
It
can
be
obtained
in
all
cases
because
it
is
obtained
from
two
different
MRI
views
.
The
normal
value
is
close
to
1
.
It
can
be
used
to
measure
patellar
instability
on
the
axial
plane
in
patients
with
OPI
,
especially
in
the
most
severe
cases
.
Diseases
Validation
Diseases presenting
"severe cases"
symptom
coats disease
congenital diaphragmatic hernia
dentin dysplasia
dentinogenesis imperfecta
erythropoietic protoporphyria
hereditary cerebral hemorrhage with amyloidosis
hydrocephalus with stenosis of the aqueduct of sylvius
locked-in syndrome
megacystis-microcolon-intestinal hypoperistalsis syndrome
neuralgic amyotrophy
proteus syndrome
scrub typhus
trochlear dysplasia
typhoid
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