Haj-Mirzaian Arya, Thawait Gaurav K, Tanaka Miho J, Demehri Shadpour
*Tehran University of Medical Sciences, Tehran, Iran Departments of †Radiology ‡Orthopaedic Surgery, Johns Hopkins University, Baltimore, MD.
Sports Med Arthrosc Rev. 2017 Jun;25(2):64-71. doi: 10.1097/JSA.0000000000000148.
Patellofemoral instability (PI) is defined as single or multiple episodes of patellar dislocation. Imaging modalities are useful for characterization of patellar malalignment, maltracking, underlying morphologic abnormalities, and stabilizing soft-tissue injuries. Using these findings, orthopedic surgeons can decide when to operate, determine the best operation, and measure degree of correction postoperatively in PI patients. Also, these methods assist with PI diagnosis in some suspicious cases. Magnetic resonance imaging is the preferred method especially in the setting of acute dislocations. Multidetector computed tomography allows a more accurate assessment for malalignment such as patellar tilt and lateral subluxation and secondary osteoarthritis. Dynamic magnetic resonance imaging and 4-dimensional computed tomography have been introduced for better kinematic assessment of the patellofemoral maltracking during extension-flexion motions. In this review article, we will discuss the currently available evidence regarding both the conventional and the novel imaging modalities that can be used for diagnosis and characterization of PI.
髌股关节不稳定（PI）被定义为髌骨单次或多次脱位。影像学检查方法有助于对髌骨排列不齐、轨迹不良、潜在形态学异常以及稳定软组织损伤进行特征性描述。利用这些检查结果，骨科医生可以决定何时进行手术、确定最佳手术方式以及测量PI患者术后的矫正程度。此外，这些方法在一些可疑病例中有助于PI的诊断。磁共振成像尤其是在急性脱位的情况下是首选方法。多排螺旋计算机断层扫描能够更准确地评估诸如髌骨倾斜和外侧半脱位以及继发性骨关节炎等排列不齐情况。动态磁共振成像和四维计算机断层扫描已被引入，以便在屈伸运动期间对髌股关节轨迹不良进行更好的运动学评估。在这篇综述文章中，我们将讨论目前可用于PI诊断和特征描述的传统及新型影像学检查方法的现有证据。
