There is no patella alta or patellar subluxation.
Femoral trochlea looks a bit shallow, but there is no chondromalacia and
MPFL is normal.
The Knee was positioned in approx 20 degrees flexion and I measured TT-TG
of 13.6mm which is close to normal range.
[image: 28F referred for PF syndrome.jpg]
I’m wondering what this linear dark band is….there seems to be
surrounding soft tissue edema in the region of the pre-femoral fat pad
where we often see friction related edema with patellar maltracking.
But it surrounds this band…and there is no edema in the superolateral
infrapatellar fat pad, or other findings to suggest maltracking.
[image: 28F referred for PF syndrome (1).jpg]
In the Sag and Ax PDFS you see all the edema surrounding the caudal aspect
of that band.
[image: 28F referred for PF syndrome (2).jpg]
I can’t find an anomalous femoral insertion of any of the vastus
muscles….do you have any ideas what this might be?
[image: 28F referred for PF syndrome (3).jpg]
2 thoughts on “28F referred to evaluate Patellofemoral Syndrome”
hilary.umans
Thanks to Christos Loupatatzis and Don Resnick I have my answer.
It is obviously the a very thin genu articularis muscle.
Don added: The appearance of this structure is so variable; it can be huge
in athletes as I have seen in NFL players, or it can be stringy. There are
several articles such as the one that I sent you that describe the complex
anatomy of the genu articularis muscle. I have never diagnosed an injury of
it nor do I know if such injuries are reported in the literature, but as it
attaches to the suprapatellar pouch, perhaps it can be edematous in persons
with altered patellar tracking. I have seen similar edema about the
ligamentum mucosum (which attaches to the inferior apex of the patella) in
persons with altered patellar tracking with or without the typical
superolateral Hoffa’s fat pad edema. Also, tears of the ligamentum mucosum
can accompany patellar dislocations.
Here’s a good reference to check out:
[image: Screen Shot 2022-02-28 at 5.07.09 PM.png]
[gallery]
ocad-msk
nice case;
see additional info Get a kick out of this: the spectrum of knee extensor mechanism injuries
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Get a kick out of this: the spectrum of knee extensor mechanism injuries
At the end of this article, the reader should be able to (1) recognise normal anatomy and anatomical variants of…
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Best,
Frank
Thanks to Christos Loupatatzis and Don Resnick I have my answer.It is obviously the a very thin genu articularis muscle.
Don added: The appearance of this structure is so variable; it can be huge in athletes as I have seen in NFL players, or it can be stringy. There are several articles such as the one that I sent you that describe the complex anatomy of the genu articularis muscle. I have never diagnosed an injury of it nor do I know if such injuries are reported in the literature, but as it attaches to the suprapatellar pouch, perhaps it can be edematous in persons with altered patellar tracking. I have seen similar edema about the ligamentum mucosum (which attaches to the inferior apex of the patella) in persons with altered patellar tracking with or without the typical superolateral Hoffa’s fat pad edema. Also, tears of the ligamentum mucosum can accompany patellar dislocations.
Here’s a good reference to check out:
There is no patella alta or patellar subluxation.Femoral trochlea looks a bit shallow, but there is no chondromalacia and MPFL is normal.The Knee was positioned in approx 20 degrees flexion and I measured TT-TG of 13.6mm which is close to normal range.
I’m wondering what this linear dark band is….there seems to be surrounding soft tissue edema in the region of the pre-femoral fat pad where we often see friction related edema with patellar maltracking.But it surrounds this band…and there is no edema in the superolateral infrapatellar fat pad, or other findings to suggest maltracking.
In the Sag and Ax PDFS you see all the edema surrounding the caudal aspect of that band.
I can’t find an anomalous femoral insertion of any of the vastus muscles….do you have any ideas what this might be?
It is obviously the a very thin genu articularis muscle.
Don added: The appearance of this structure is so variable; it can be huge
in athletes as I have seen in NFL players, or it can be stringy. There are
several articles such as the one that I sent you that describe the complex
anatomy of the genu articularis muscle. I have never diagnosed an injury of
it nor do I know if such injuries are reported in the literature, but as it
attaches to the suprapatellar pouch, perhaps it can be edematous in persons
with altered patellar tracking. I have seen similar edema about the
ligamentum mucosum (which attaches to the inferior apex of the patella) in
persons with altered patellar tracking with or without the typical
superolateral Hoffa’s fat pad edema. Also, tears of the ligamentum mucosum
can accompany patellar dislocations.
Here’s a good reference to check out:
[image: Screen Shot 2022-02-28 at 5.07.09 PM.png]
[gallery]
see additional info Get a kick out of this: the spectrum of knee extensor mechanism injuries
|
|
|
| | |
|
|
|
| |
Get a kick out of this: the spectrum of knee extensor mechanism injuries
At the end of this article, the reader should be able to (1) recognise normal anatomy and anatomical variants of…
|
|
|
Best,
Frank
Thanks to Christos Loupatatzis and Don Resnick I have my answer.It is obviously the a very thin genu articularis muscle.
Don added: The appearance of this structure is so variable; it can be huge in athletes as I have seen in NFL players, or it can be stringy. There are several articles such as the one that I sent you that describe the complex anatomy of the genu articularis muscle. I have never diagnosed an injury of it nor do I know if such injuries are reported in the literature, but as it attaches to the suprapatellar pouch, perhaps it can be edematous in persons with altered patellar tracking. I have seen similar edema about the ligamentum mucosum (which attaches to the inferior apex of the patella) in persons with altered patellar tracking with or without the typical superolateral Hoffa’s fat pad edema. Also, tears of the ligamentum mucosum can accompany patellar dislocations.
Here’s a good reference to check out:
There is no patella alta or patellar subluxation.Femoral trochlea looks a bit shallow, but there is no chondromalacia and MPFL is normal.The Knee was positioned in approx 20 degrees flexion and I measured TT-TG of 13.6mm which is close to normal range.
I’m wondering what this linear dark band is….there seems to be surrounding soft tissue edema in the region of the pre-femoral fat pad where we often see friction related edema with patellar maltracking.But it surrounds this band…and there is no edema in the superolateral infrapatellar fat pad, or other findings to suggest maltracking.
In the Sag and Ax PDFS you see all the edema surrounding the caudal aspect of that band.
I can’t find an anomalous femoral insertion of any of the vastus muscles….do you have any ideas what this might be?
[gallery]