Beaconsfield T, Pintore E, Maffulli N, Petri G J
John Radcliffe Hospital, Department of Radiology, Headington, Oxford, United Kingdom.
Clin Orthop Relat Res. 1994 Nov(308):18-28.
This paper analyzes some of the radiologic measurements used in the diagnosis and management of patellofemoral disorders. Measurements such as condylar width and height and patellar height from the true lateral view are helpful to determine the type and severity of intercondylar dysplasia. Skyline views provide information on the type and degree of patellar subluxation and dysplasia, especially of the medial aspect of the trochlear groove. In asymptomatic subjects, the trochlear angle does not exceed 140 degrees, and the lateral medial intercondylar ratio in dysplasia is > 1.7. Scanograms specifically assess the longitudinal axis of the lower limb. Computed tomography (CT) measurements for patellar subluxation do not provide significant additional information over that provided by skyline views. The average distance between the anterior tibial tuberosity and the trochlear groove is normally 13 mm, and a distance > 20 mm associated with knee pain should probably warrant surgery. Because of multiplanar facilities and exposure to nonionizing radiations, magnetic resonance imaging is progressively replacing CT scanning for quantitative and qualitative measurements, at least in a research environment. Its use in routine clinical practice is not yet warranted, given its high costs.
本文分析了一些用于髌股关节疾病诊断和治疗的放射学测量方法。从真正的侧位片测量髁宽度、高度以及髌骨高度等，有助于确定髁间发育不良的类型和严重程度。髌股关节切线位片可提供髌骨半脱位和发育不良的类型及程度信息，尤其是滑车沟内侧方面的信息。在无症状受试者中，滑车角不超过140度，发育不良时内外侧髁间比率>1.7。扫描图专门评估下肢的纵轴。计算机断层扫描（CT）测量髌骨半脱位，相较于髌股关节切线位片，并未提供显著更多的额外信息。胫骨结节与滑车沟之间的平均距离通常为13毫米，距离>20毫米且伴有膝关节疼痛可能需要手术治疗。由于具有多平面功能以及可避免电离辐射，磁共振成像（MRI）正逐渐取代CT扫描进行定量和定性测量，至少在研究环境中如此。鉴于其成本高昂，目前在常规临床实践中尚未得到广泛应用。
