RESUMEN
OBJECTIVE: To determine if computed tomography of the patellofemoral joint has any advantage over standard radiologic techniques in the evaluation of recurrent patellar subluxation. DESIGN: A case series. SETTING: A tertiary children's hospital out-patient clinic. PARTICIPANTS: Forty consecutive adolescents with a clinical diagnosis of recurrent patellar subluxation (study group) and 14 volunteers with normal knees (control group). INTERVENTIONS: A standardized radiologic protocol, including axial views of the patella at 30 degrees of knee flexion, with and without external torsion of the tibia, and computed tomography (CT) of the patella at 15 degrees of knee flexion. MAIN OUTCOME MEASURES: The lateral patellofemoral angle on the axial views and on the CT scan and patellar centralization on the CT scan. RESULTS: In the control group, no radiologic evidence of recurrent patellar subluxation was found. In the study group, an abnormal lateral patellofemoral angle was found in 25% of axial views; this rate increased to 42% with external rotation and 86% on the CT scan. Patellar centralization was abnormal in 79% of cases. CONCLUSIONS: CT of the patellofemoral joint is more sensitive than standard radiographs for the diagnosis of recurrent patellar subluxation. The use of CT is recommended when standard radiographs appear normal.
Asunto(s)
Luxaciones Articulares/diagnóstico por imagen , Rótula/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Adolescente , Humanos , Articulación de la Rodilla/diagnóstico por imagen , RecurrenciaRESUMEN
Fourteen patients with cerebral palsy (CP), 12 with Friedreich's ataxia (FA) and 26 with adolescent idiopathic scoliosis (AIS) were studied to determine whether the shape of the scoliosis curve differs between these categories. The slope of the regression relationship between vertebral rotation and lateral deviation was greater for the CP group compared with the FA and AIS groups. The authors conclude that the scoliosis curve pattern of children with Friedreich's ataxia and adolescent idiopathic scoliosis is similar. In contrast, the scoliosis curve of children with CP was distinctly different, with more rotation of the apical vertebrae into the convexity of the scoliosis curve (transverse plane deformity) in relation to the amount of lateral deviation of the apical vertebrae from the spinal axis (coronal plane deformity).