Patellofemoral Osteoarthritis

Patellofemoral osteoarthritis is an extremely common cause of anterior knee pain. This is encountered primarily in older individuals, but can be seen in younger patients with accelerated degenerative changes brought on by comor-bidities such as obesity. The classic radiographic features of PO include loss of articular cartilage with joint space narrowing, subchondral sclerosis and/or cyst formation, and osteophyte formation along the posterior margin of the patella. The symptoms commonly seen with PO include morning knee joint stiffness, loss of mobility, pain with ambulation (particularly walking up an incline or along a flight of stairs), and weakness about the knee joint.

Early clinical signs and symptoms may precede detectable conventional radiographic abnormalities. MRI, however, is especially sensitive to soft tissue and bone abnormalities. Fast spin echo T2 fat-saturated sequences are sensitive and specific for focal cartilage abnormalities [23]. MR findings in PO include cartilage surface thinning and irregularity, fine delineation of focal articular cartilage loss, or cartilage fissuring. Osteophytes are also common. There may be high T2 signal changes in the patella if there is significant marrow edema (Fig. 6).

Mri Image Chondromalacia Patella

Fig. 5. Chondromalacia patella. (A) T2-weighted image shows focal abnormal high signal within the patellar cartilage. (B) Diagram of CP grading scheme, pathologic findings. (From Conway WF, Hayes CW, Loughran T, et al. Cross-sectional imaging of the patellofemoral joint and surrounding structures. Radiographics 1991;11:195-217; with permission.)

Fig. 5. Chondromalacia patella. (A) T2-weighted image shows focal abnormal high signal within the patellar cartilage. (B) Diagram of CP grading scheme, pathologic findings. (From Conway WF, Hayes CW, Loughran T, et al. Cross-sectional imaging of the patellofemoral joint and surrounding structures. Radiographics 1991;11:195-217; with permission.)

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