Adult ; Bone Neoplasms ; diagnosis ; diagnostic imaging ; pathology ; Diagnosis, Differential ; Diaphyses ; diagnostic imaging ; pathology ; Humans ; Knee Joint ; diagnostic imaging ; pathology ; Lipoma ; diagnosis ; diagnostic imaging ; pathology ; Magnetic Resonance Imaging ; Male ; Radiography ; Tibia ; diagnostic imaging ; pathology

INTRODUCTIONThe fabella, a sesamoid bone sometimes found in the lateral head of the gastrocnemius muscle, often articulates directly with the lateral femoral condyle. This study aimed to determine the incidence of fabellae in an Asian population and to characterise the radiological features of the fabella.

METHODSElectronic radiographs and magnetic resonance imaging films of 80 consecutive patients who underwent knee arthroscopy between May 2005 and October 2009 were reviewed to determine the presence and characteristics of the fabella.

RESULTSThe incidence of fabellae was 31.25% in our study cohort. The median length, thickness, width and distance of the fabella from the lateral femoral condyle were 7.06 mm, 4.89 mm, 6.12 mm and 33.19 mm, respectively. The fabella was consistently bony and located in the lateral head of the gastrocnemius, with 52% of the fabellae having an articulating facet. Fabellae in men were found to be larger than in women, although the difference was not statistically significant. The presence of an articulating groove was associated with increased size of the fabella, but not with the distance between the fabella and its insertion onto the lateral head of the gastrocnemius.

CONCLUSIONThe incidence of fabellae in our population was lower than that in regional studies. They were consistently bony and not all had articulating grooves on the lateral femoral condyle. We found that the larger the fabella, the higher the chances of it having an articulating groove. By defining the radiological characteristics of the fabella, we provide objective parameters to help differentiate the fabella from other loose bodies or calcifications in the knee.

Adolescent ; Adult ; Arthroscopy ; Asia ; Cohort Studies ; Female ; Humans ; Incidence ; Knee Joint ; diagnostic imaging ; pathology ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Muscle, Skeletal ; diagnostic imaging ; pathology ; Radiography ; Sesamoid Bones ; diagnostic imaging ; pathology ; Sex Factors ; Young Adult

OBJECTIVESTo investigate whether tibial intercondylar hyperplasia can cause anterior cruciate ligament (ACL) injuries.

METHODSFrom February 2009 to October 2012, 58 cases (including 70 knees) with knee osteoarthritis (KOA) without trauma history were selected from the out-patient department of orthopaedics in Guang'anmen Hospital attached to China Academy of Chinese Medical Science. All cases were tested by MRI scanning, then vertical height of the medial and lateral intercondylar spine in coronal position and the area of abnormal signal of ACL in sagittal position were tested from patients. Correlation between the height of intercondylar spine and the area of abnormal signal of ACL were analyzed.

RESULTSFives cases of 58 cases( 70 knees) were excluded from episome in knee joint, and other 65 knees were in accordance with the inclusion criteria. Among them, there were 10 males and 48 females aged from 39 to 79 years old with an average of 61 years old. The vertical height of the medial intercondylar spine was (10.02 +/- 1.46) mm and lateral was (8.92 +/- 1.69) mm. The area of abnormal signal ACL was (318.42 +/- 130.10) mm2. There was positive correlation between the height of medial intercondylar spine and the area of abnormal signal of ACL (r=0.06, P=0.00). But there was no correlation between lateral intercondylar spine and the area of abnormal signal of ACL (P=0.10).

CONCLUSIONThe height of medial intercondylar spine and the area of abnormal signal of ACL is positively correlated. The clinical significance is in study, while the clinical meaning still need further study.

Adult ; Aged ; Anterior Cruciate Ligament ; abnormalities ; diagnostic imaging ; surgery ; Female ; Humans ; Hyperplasia ; diagnostic imaging ; surgery ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Osteoarthritis, Knee ; diagnostic imaging ; surgery ; Radiography ; Tibia ; diagnostic imaging ; pathology ; surgery

Ganglion cysts are more commonly associated with the anterior cruciate ligament than the posterior cruciate ligament (PCL). A literature review showed that all reported cases of ganglion cysts to date involved adults. We report a rare case of ganglion cyst in the PCL of a four-year-old boy, and discuss its aetiology, clinical presentation, imaging features and management. Ganglion cysts of the PCL may be confused with meniscal cysts arising from tears of the posterior horn of the medial meniscus on magnetic resonance (MR) imaging. Hence, the posterior horn of the medial meniscus has to be carefully evaluated to rule out a tear. MR imaging is the method of choice to confirm diagnosis, and arthroscopic resection is a safe treatment modality even in children.
Arthroscopy ; Child, Preschool ; Ganglion Cysts ; diagnosis ; surgery ; Humans ; Knee Joint ; diagnostic imaging ; Magnetic Resonance Imaging ; Male ; Posterior Cruciate Ligament ; injuries ; pathology ; Radiography

OBJECTIVETo study the application of stress X-ray of knee joint for the diagnosis ot medial collateral ligament injury.

METHODSFrom January 2008 to June 2011, 46 patients with medial collateral ligament injury were reviewed. Among the patients, 32 patients were male and 14 patients were female, ranging in age from 28 to 72 years, with an average of (49.46 +/- 22.54) years. Left knee joint injuries occurred in 22 patients, and 24 patients had injuries in right knee joint. Thirty-one patients were treated with surgical method, and 15 patients were treated with conservative method including 1 patient finally received operation after 3 months treatment with conservative method without effect. The injury side and normal side were observed by X-ray under stress and non-stress, as well as MRI. Operation was used to treat patients with medial gap markedly widen and the deep layer of medial collateral ligament injury in MRI. A line (line A) was drawn from medial condyle to lateral condyle of tibia platform. The line A was translated to the inner margin of condylus medialis femoris, which was line B. The perpendicular distance was measured, which was line C. The ration of space difference (R) was calculated by (space at stress force of injured side-space at non-stress force of injured side)/(space at stress force of normal side-space at non-stress force of normal side). The relationship between R and ligament injury type were investigated.

RESULTSThere were 17 patients with injuries of superficial lamella, 21 patients with injuries of deep lamella. Eight patients had associated injuries of articular capsule and posterior cruciate ligament. When R value was between 1.51 to 5.24, the injury of superficial ligament was found in 15 patients, actual injuries were found in 17 patients. When R value between 5.28 and 13.85, the injuries of bathypelagic ligament were found in 19 patients, actual injuries were found in 21 patients. When R value was between 15.61 and 26.25, the associated injuries of articular capsule and posterior cruciate ligament were found in 7 patients, actual injuries were found in 8 patients.

CONCLUSIONUsing the specific value as the standard of measurement can provide the quantizatily fractionation of the medial collateral ligament injury.

Adult ; Aged ; Female ; Humans ; Knee Joint ; diagnostic imaging ; pathology ; Magnetic Resonance Imaging ; methods ; Male ; Medial Collateral Ligament, Knee ; injuries ; Middle Aged ; Radiography

Unlike meniscal tears and chondral defects, the mucoid degeneration of the anterior cruciate ligament (ACL) is a rare cause of knee pain and there have been no case reports of mucoid degeneration of both the ACL and the posterior cruciate ligament (PCL). A 48-year-old-male patient presented with knee pain and limitation of motion. The patient's magnetic resonance imaging, arthroscopic findings, and pathologic diagnosis confirmed a clinical diagnosis of mucoid degeneration of both the ACL and the PCL. The symptoms disappeared after arthroscopic partial excision of the ACL and PCL.
Anterior Cruciate Ligament/*pathology/radiography ; Arthralgia/etiology ; Humans ; Joint Diseases/diagnosis/*pathology/radiography ; Knee Joint/*pathology/radiography ; Male ; Middle Aged ; Posterior Cruciate Ligament/*pathology/radiography

BACKGROUND: The clinical and radiologic features of radial tears of the medial meniscus posterior horn were compared with those of horizontal tears. METHODS: From January 2007 to December 2008, 387 consecutive cases of medial meniscal tears were treated arthroscopically. Among these, 91 were radial tears in the medial meniscus posterior horn, and 95 were horizontal tears in the posterior segment of the medial meniscus. The patients' data (age, gender, duration of symptom, body mass index, and injury history), radiographic findings (Kellgren and Lawrence score, posterior tibial slope, and femorotibial angle), and chondral lesions were recorded. RESULTS: The patient factors of age, gender, and body mass index were related to radial tears of the medial meniscus posterior horn. Radial tears were significantly correlated with Kellgren and Lawrence score, varus alignment, posterior tibial slope, and severity of the chondral lesion. CONCLUSIONS: Radial tears of the medial meniscus posterior horn are a unique clinical entity that are associated with older age, females and obesity, and are strongly associated with an increased incidence and severity of cartilage degeneration compared to horizontal tears.
Adult ; Age Factors ; Aged ; Arthroscopy ; Body Mass Index ; Female ; Humans ; Knee Injuries/*pathology/radiography/surgery ; Male ; Menisci, Tibial/*injuries/*pathology/radiography/surgery ; Middle Aged ; Retrospective Studies ; Sex Factors

OBJECTIVETo explore the indications of arthroscope for the treatment of knee osteoarthritis and investigate the correlation between knee osteoarthritis imaging and effects of arthroscope.

METHODSFrom 2005.8 to 2008.4, 86 patients with knee osteoarthritis underwent arthroscope examination and treatment. Among the patients, 44 patients were male, and 42 patients were female, ranging in age from 46 to 67 years, averaged 56.3 years. Arthrodial cartilage of knee was graded by ICRS MR, and by Kellgern Laqrence X-ray. All the patients were followed up, and the duration ranged from 12 to 30 months. The Lysholm score was evaluated at the follow-up time.

RESULTSAmong 86 knees in 86 cases, cartilage injury degree of knees was graded as follows: grade 4 in 30 cases, grade 3 in 22 cases, grade 2 in 20 cases, grade 1 in 12 cases, grade 0 in 2 cases, mean grade (2.77 +/- 1.138). Postoperative Lysholm score ranged from 59 to 100, averaged (95.17 +/- 7.556), Kendall's correlation coefficient was -0.089, P = 0.317. There was no correlations between cartilage injury degree and Lysholm score. X-ray of knees was graded as follows: grade 4 in 0 cases, grade 3 in 24 cases, grade 2 in 38 cases, grade 1 in 17 cases, grade 0 in 7 cases, mean grade was (2.13 +/- 0.67), the Kendall's correlation coefficient was -0.851 with negative correlations (P = 0.036) between postoperative Lysholm score and K/L grade.

CONCLUSIONThere is no correlation between the grade of knee cartilage injury confirmed by MRI (1.5T) and effects of arthroscopy, and the grade is not a gold standard as an operation indication in arthroscope procedure. The K/L grade in X-ray had important effects.

Aged ; Arthroscopes ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Osteoarthritis, Knee ; diagnostic imaging ; pathology ; Radiography

OBJECTIVETo study the relationship between clinical syndromes and X-ray manifestation of knee osteoarthritis (KOA), so as to provide evidence for clinical diagnosis and treatment.

METHODSSeventy-eight patients (108 knees) with KOA from out-patient clinic of orthopedic were collected, aged from 41 to 77, including 65 females (89 knees) and 13 males (19 knees). Questionnair investigation of Lequesne index was performed among all these patients and the Lequesne index was calculated. And all these patients were divided into two groups, mild group (Lequesne index < or = 8) and severe group (Lequesne index > 8). Weight-bearing anteriorposterior and lateral plain film of knee joint and patellofemoral Skyline plain flim was taken. Joint space narrowing, osteophyte formation, subchondral osteosclerosis and subchondral cystic degeneration were evaluated. The lower limb alignment and lateral patella angle were detected. The correlation of the Lequesne index and X-ray manifestation was analyzed by logistic regression analysis.

RESULTSThere were significant differences between mild and severe groups in the following indexes: lateral tibiofemoral joint space narrowing, the medial retropatellar space narrowing, medial and lateral tibia osteophytes, medial and tibial femur femur osteophytes, medial and lateral trochlea osteophytes, lateral patella osteophytes, tibia introcondylar osteophytes (P<0.05). The results of the logistic regression analysis showed that the lateral femur osteophytes were the most important radiologic manifestation to evaluate the severity degree of KOA,with the minimum associated probability (0.009) and the maximum wald value (6.779).

CONCLUSIONWhen evaluating the severity degree of KOA,the joint space narrowing and osteophytes are the most sigenificant radiologic manifestation which includs the lateral tibiofemoral joint space narrowing, the medial retropatellar space narrowing, medial and lateral tibia osteophytes, medial and lateral femur osteophytes, medial and lateral trochlea osteophytes, lateral patella osteophyte, tibial intercondylar osteophyte.

Adult ; Aged ; Female ; Humans ; Logistic Models ; Male ; Middle Aged ; Osteoarthritis, Knee ; diagnostic imaging ; pathology ; Radiography

Osteoarthritis (OA) is a chronic joint disease that involves degeneration of articular cartilage, limited intra-articular inflammation manifested by synovitis and changes in the subchondral bone. After the articular cartilage's stability and complex structure in the framework of pressure-proof were destruct, the ability to repair by itself was weak. Therefore early diagnosis in the treatment of osteoarthritis is a focal ponit. This paper addressed on the characteristics of diagnosis of OA in the relevant objective diagnostic methods.
Adult ; Aged ; Bone Density ; physiology ; Bone and Bones ; diagnostic imaging ; pathology ; Calcification, Physiologic ; Cartilage, Articular ; diagnostic imaging ; pathology ; Female ; Humans ; Joints ; diagnostic imaging ; pathology ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Osteoarthritis ; diagnosis ; epidemiology ; Osteoarthritis, Knee ; diagnosis ; diagnostic imaging ; Radiography ; Radionuclide Imaging ; Synovial Membrane ; diagnostic imaging ; pathology ; Ultrasonography