Department of Anesthesiology and Pain Medicine, Comprehensive Pain Center, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
Department of Anesthesiology and Pain Medicine, Catholic Kwandong University of Korea College of Medicine, International ST. Mary`s Hospital, Incheon, Republic of Korea.
Medicine (Baltimore). 2023 Aug 18;102(33):e34307. doi: 10.1097/MD.0000000000034307.
Chondromalacia patella (CMP) is abnormal softening of the cartilage of the underside the patella. It is a cause of anterior knee pain. Previous study has demonstrated that the patellar cartilage hypertrophy is correlated with early signs of CMP (Grade 1 or 2). However, no studies have investigated the clinical cutoff value of patella cartilage hypertrophy. Thus, we devised the patellar cartilage cross-sectional area (PCCSA) as a new predictive parameter for diagnosing the CMP. The purpose of this research was to compare MR measured PCCSA between CMP patients and gender matched healthy controls. The PCCSA samples were collected from 50 patients with CMP, and from 50 healthy controls who underwent knee MRI with no evidence of CMP. The T2-weighted turbo spin echo transverse MRI images were acquired. We measured the PCCSA on MRI using a PACS system. The PCCSA was measured on the axial angled sections through the whole images by drawing outlines. The average PCCSA was 104.28 ± 23.28 mm2 in the healthy controls and 134.09 ± 26.55 mm2 in the CMP group. CMP patients had significantly higher PCCSA (P < .001). Regarding the validity of PCCSA as predictors of CMP, Receiver Operating Characteristic curve analysis showed that the best cutoff point for the PCCSA was 116.24 mm2, with 72.0% sensitivity, 72.0% specificity, and the area under curve (AUC) of 0.79 (0.71-0.88). The PCCSA is a sensitive measurement parameter to predict low grade CMP. Thus, to evaluate CMP patients, the treating physician carefully inspect the PCCSA.
髌骨软化症（CMP）是髌骨下软骨的异常软化。它是引起前膝疼痛的原因。先前的研究表明，髌骨软骨肥大与 CMP 的早期迹象（1 级或 2 级）有关。但是，尚无研究探讨髌骨软骨肥大的临床临界值。因此，我们设计了髌骨软骨横截面积（PCCSA）作为诊断 CMP 的新预测参数。本研究旨在比较 CMP 患者和性别匹配的健康对照组之间通过 MRI 测量的 PCCSA。从 50 名 CMP 患者和 50 名接受 MRI 检查且无 CMP 证据的健康对照组中收集 PCCSA 样本。获取 T2 加权涡轮自旋回波横向 MRI 图像。我们使用 PACS 系统在 MRI 上测量 PCCSA。通过绘制轮廓，在整个图像的轴向斜截面测量 PCCSA。健康对照组的 PCCSA 平均值为 104.28±23.28mm2，CMP 组为 134.09±26.55mm2。CMP 患者的 PCCSA 明显更高（P<0.001）。关于 PCCSA 作为 CMP 预测指标的有效性，ROC 曲线分析显示 PCCSA 的最佳截断点为 116.24mm2，灵敏度为 72.0%，特异性为 72.0%，曲线下面积（AUC）为 0.79（0.71-0.88）。PCCSA 是预测低级别 CMP 的敏感测量参数。因此，在评估 CMP 患者时，治疗医生应仔细检查 PCCSA。
