Standardization of patellofemoral morphology in the pediatric knee
Background Our understanding of osseous morphology and pathology of the patellofemoral joint continues to improve with the use of magnetic resonance imaging (MRI), but a paucity of data currently exists in the pediatric population. Objective We aim to formulate a reproducible means of quantitative a...
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| Veröffentlicht in: | Pediatric radiology 2016-02, Vol.46 (2), p.255-262 |
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| creator | Mundy, Andrew Ravindra, Amy Yang, Jingzhen Adler, Brent H. Klingele, Kevin E. |
| description | Background
Our understanding of osseous morphology and pathology of the patellofemoral joint continues to improve with the use of magnetic resonance imaging (MRI), but a paucity of data currently exists in the pediatric population.
Objective
We aim to formulate a reproducible means of quantitative assessment of patellofemoral morphology in children using MRI and to describe morphological changes based on sex and age.
Materials and methods
We identified 414 children presenting between 2002 and 2014 who obtained a knee MRI to evaluate for knee pain or clinically suspected knee pathology. After application of inclusion criteria, 144 “normal” MRIs in 131 children (71 boys, 60 girls) were included in the analysis. The following MRI measurements were recorded: lateral trochlear inclination, trochlear facet asymmetry, trochlear depth, tibial tuberosity-trochlear groove distance, sulcus angle and patellar height ratio. To assess intraobserver reliability, measurements in 30 randomly selected children were repeated. Differences between patient age and sex were assessed using independent
t
-tests and adjusted regression analysis.
Results
All recorded measurements had strong to very strong inter- and intraobserver reliability: lateral trochlear inclination (0.91/0.82), trochlear facet asymmetry (0.81/0.83), trochlear depth (0.83/0.90), tibial tuberosity-trochlear groove distance (0.97/0.87), sulcus angle (0.84/0.78) and patellar height ratio (0.96/0.83). When age and sex were mutually adjusted, statistically significant differences between males and females were observed in trochlear depth (
P
= 0.0084) and patellar height ratio (
P
= 0.0035). However, statistically significant age differences were found on all measurements except for lateral trochlear inclination. As expected, mean measurement values approached adult norms throughout skeletal maturation suggestive of age-dependent patellofemoral maturation.
Conclusion
Our data verify the development of patellofemoral morphology with advancing age. We found that six of the most commonly used patellofemoral measurements in adults can be accurately reproduced regardless of age. |
| doi_str_mv | 10.1007/s00247-015-3459-9 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1762346229</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3939285421</sourcerecordid><originalsourceid>FETCH-LOGICAL-c442t-a0a5e315267dbbea3ebd8718f3302263d0dcde926d741c32366736b7eccffe453</originalsourceid><addsrcrecordid>eNp1kD1PwzAURS0EoqXwA1hQJBaWgL9iJyNUfElIDMBsOfFLm5LEwU6G8utxlIIQEovf4PPuuzoInRJ8STCWVx5jymWMSRIznmRxtofmhDMakyxL99EcM0xizHk2Q0febzDGLCHsEM2oYCnhVMzRzUuvW6OdqT51X9k2smXU6R7q2pbQWKfrKLzd2tZ2tY2qNurXEHVgKt27qojeW4BjdFDq2sPJbi7Q293t6_Ihfnq-f1xeP8UF57SPNdYJMJJQIU2eg2aQm1SStGQM01DIYFMYyKgwkpOCUSaEZCKXUBRlCTxhC3Qx5XbOfgzge9VUvghNdQt28IpIQRkXlGYBPf-Dbuzg2tBupIggiaAyUGSiCme9d1CqzlWNdltFsBoFq0mwCoLVKFiNyWe75CFvwPxsfBsNAJ0AH77aFbhfp_9N_QL7fIVZ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1761615627</pqid></control><display><type>article</type><title>Standardization of patellofemoral morphology in the pediatric knee</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Mundy, Andrew ; Ravindra, Amy ; Yang, Jingzhen ; Adler, Brent H. ; Klingele, Kevin E.</creator><creatorcontrib>Mundy, Andrew ; Ravindra, Amy ; Yang, Jingzhen ; Adler, Brent H. ; Klingele, Kevin E.</creatorcontrib><description>Background
Our understanding of osseous morphology and pathology of the patellofemoral joint continues to improve with the use of magnetic resonance imaging (MRI), but a paucity of data currently exists in the pediatric population.
Objective
We aim to formulate a reproducible means of quantitative assessment of patellofemoral morphology in children using MRI and to describe morphological changes based on sex and age.
Materials and methods
We identified 414 children presenting between 2002 and 2014 who obtained a knee MRI to evaluate for knee pain or clinically suspected knee pathology. After application of inclusion criteria, 144 “normal” MRIs in 131 children (71 boys, 60 girls) were included in the analysis. The following MRI measurements were recorded: lateral trochlear inclination, trochlear facet asymmetry, trochlear depth, tibial tuberosity-trochlear groove distance, sulcus angle and patellar height ratio. To assess intraobserver reliability, measurements in 30 randomly selected children were repeated. Differences between patient age and sex were assessed using independent
t
-tests and adjusted regression analysis.
Results
All recorded measurements had strong to very strong inter- and intraobserver reliability: lateral trochlear inclination (0.91/0.82), trochlear facet asymmetry (0.81/0.83), trochlear depth (0.83/0.90), tibial tuberosity-trochlear groove distance (0.97/0.87), sulcus angle (0.84/0.78) and patellar height ratio (0.96/0.83). When age and sex were mutually adjusted, statistically significant differences between males and females were observed in trochlear depth (
P
= 0.0084) and patellar height ratio (
P
= 0.0035). However, statistically significant age differences were found on all measurements except for lateral trochlear inclination. As expected, mean measurement values approached adult norms throughout skeletal maturation suggestive of age-dependent patellofemoral maturation.
Conclusion
Our data verify the development of patellofemoral morphology with advancing age. We found that six of the most commonly used patellofemoral measurements in adults can be accurately reproduced regardless of age.</description><identifier>ISSN: 0301-0449</identifier><identifier>EISSN: 1432-1998</identifier><identifier>DOI: 10.1007/s00247-015-3459-9</identifier><identifier>PMID: 26381426</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adolescent ; Aging - pathology ; Anatomic Landmarks - pathology ; Child ; Child, Preschool ; Female ; Humans ; Imaging ; Infant ; Infant, Newborn ; Magnetic Resonance Imaging - standards ; Male ; Medicine ; Medicine & Public Health ; Neuroradiology ; Nuclear Medicine ; Observer Variation ; Oncology ; Original Article ; Patellofemoral Joint - pathology ; Pediatrics ; Practice Guidelines as Topic ; Radiology ; Radiology - standards ; Reference Values ; Reproducibility of Results ; Sensitivity and Specificity ; Ultrasound</subject><ispartof>Pediatric radiology, 2016-02, Vol.46 (2), p.255-262</ispartof><rights>Springer-Verlag Berlin Heidelberg 2015</rights><rights>Springer-Verlag Berlin Heidelberg 2016</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c442t-a0a5e315267dbbea3ebd8718f3302263d0dcde926d741c32366736b7eccffe453</citedby><cites>FETCH-LOGICAL-c442t-a0a5e315267dbbea3ebd8718f3302263d0dcde926d741c32366736b7eccffe453</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00247-015-3459-9$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00247-015-3459-9$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26381426$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mundy, Andrew</creatorcontrib><creatorcontrib>Ravindra, Amy</creatorcontrib><creatorcontrib>Yang, Jingzhen</creatorcontrib><creatorcontrib>Adler, Brent H.</creatorcontrib><creatorcontrib>Klingele, Kevin E.</creatorcontrib><title>Standardization of patellofemoral morphology in the pediatric knee</title><title>Pediatric radiology</title><addtitle>Pediatr Radiol</addtitle><addtitle>Pediatr Radiol</addtitle><description>Background
Our understanding of osseous morphology and pathology of the patellofemoral joint continues to improve with the use of magnetic resonance imaging (MRI), but a paucity of data currently exists in the pediatric population.
Objective
We aim to formulate a reproducible means of quantitative assessment of patellofemoral morphology in children using MRI and to describe morphological changes based on sex and age.
Materials and methods
We identified 414 children presenting between 2002 and 2014 who obtained a knee MRI to evaluate for knee pain or clinically suspected knee pathology. After application of inclusion criteria, 144 “normal” MRIs in 131 children (71 boys, 60 girls) were included in the analysis. The following MRI measurements were recorded: lateral trochlear inclination, trochlear facet asymmetry, trochlear depth, tibial tuberosity-trochlear groove distance, sulcus angle and patellar height ratio. To assess intraobserver reliability, measurements in 30 randomly selected children were repeated. Differences between patient age and sex were assessed using independent
t
-tests and adjusted regression analysis.
Results
All recorded measurements had strong to very strong inter- and intraobserver reliability: lateral trochlear inclination (0.91/0.82), trochlear facet asymmetry (0.81/0.83), trochlear depth (0.83/0.90), tibial tuberosity-trochlear groove distance (0.97/0.87), sulcus angle (0.84/0.78) and patellar height ratio (0.96/0.83). When age and sex were mutually adjusted, statistically significant differences between males and females were observed in trochlear depth (
P
= 0.0084) and patellar height ratio (
P
= 0.0035). However, statistically significant age differences were found on all measurements except for lateral trochlear inclination. As expected, mean measurement values approached adult norms throughout skeletal maturation suggestive of age-dependent patellofemoral maturation.
Conclusion
Our data verify the development of patellofemoral morphology with advancing age. We found that six of the most commonly used patellofemoral measurements in adults can be accurately reproduced regardless of age.</description><subject>Adolescent</subject><subject>Aging - pathology</subject><subject>Anatomic Landmarks - pathology</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Female</subject><subject>Humans</subject><subject>Imaging</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Magnetic Resonance Imaging - standards</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Neuroradiology</subject><subject>Nuclear Medicine</subject><subject>Observer Variation</subject><subject>Oncology</subject><subject>Original Article</subject><subject>Patellofemoral Joint - pathology</subject><subject>Pediatrics</subject><subject>Practice Guidelines as Topic</subject><subject>Radiology</subject><subject>Radiology - standards</subject><subject>Reference Values</subject><subject>Reproducibility of Results</subject><subject>Sensitivity and Specificity</subject><subject>Ultrasound</subject><issn>0301-0449</issn><issn>1432-1998</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNp1kD1PwzAURS0EoqXwA1hQJBaWgL9iJyNUfElIDMBsOfFLm5LEwU6G8utxlIIQEovf4PPuuzoInRJ8STCWVx5jymWMSRIznmRxtofmhDMakyxL99EcM0xizHk2Q0febzDGLCHsEM2oYCnhVMzRzUuvW6OdqT51X9k2smXU6R7q2pbQWKfrKLzd2tZ2tY2qNurXEHVgKt27qojeW4BjdFDq2sPJbi7Q293t6_Ihfnq-f1xeP8UF57SPNdYJMJJQIU2eg2aQm1SStGQM01DIYFMYyKgwkpOCUSaEZCKXUBRlCTxhC3Qx5XbOfgzge9VUvghNdQt28IpIQRkXlGYBPf-Dbuzg2tBupIggiaAyUGSiCme9d1CqzlWNdltFsBoFq0mwCoLVKFiNyWe75CFvwPxsfBsNAJ0AH77aFbhfp_9N_QL7fIVZ</recordid><startdate>20160201</startdate><enddate>20160201</enddate><creator>Mundy, Andrew</creator><creator>Ravindra, Amy</creator><creator>Yang, Jingzhen</creator><creator>Adler, Brent H.</creator><creator>Klingele, Kevin E.</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QP</scope><scope>7RV</scope><scope>7TK</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20160201</creationdate><title>Standardization of patellofemoral morphology in the pediatric knee</title><author>Mundy, Andrew ; Ravindra, Amy ; Yang, Jingzhen ; Adler, Brent H. ; Klingele, Kevin E.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c442t-a0a5e315267dbbea3ebd8718f3302263d0dcde926d741c32366736b7eccffe453</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adolescent</topic><topic>Aging - pathology</topic><topic>Anatomic Landmarks - pathology</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Female</topic><topic>Humans</topic><topic>Imaging</topic><topic>Infant</topic><topic>Infant, Newborn</topic><topic>Magnetic Resonance Imaging - standards</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Neuroradiology</topic><topic>Nuclear Medicine</topic><topic>Observer Variation</topic><topic>Oncology</topic><topic>Original Article</topic><topic>Patellofemoral Joint - pathology</topic><topic>Pediatrics</topic><topic>Practice Guidelines as Topic</topic><topic>Radiology</topic><topic>Radiology - standards</topic><topic>Reference Values</topic><topic>Reproducibility of Results</topic><topic>Sensitivity and Specificity</topic><topic>Ultrasound</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mundy, Andrew</creatorcontrib><creatorcontrib>Ravindra, Amy</creatorcontrib><creatorcontrib>Yang, Jingzhen</creatorcontrib><creatorcontrib>Adler, Brent H.</creatorcontrib><creatorcontrib>Klingele, Kevin E.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Neurosciences Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biological Science Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Pediatric radiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mundy, Andrew</au><au>Ravindra, Amy</au><au>Yang, Jingzhen</au><au>Adler, Brent H.</au><au>Klingele, Kevin E.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Standardization of patellofemoral morphology in the pediatric knee</atitle><jtitle>Pediatric radiology</jtitle><stitle>Pediatr Radiol</stitle><addtitle>Pediatr Radiol</addtitle><date>2016-02-01</date><risdate>2016</risdate><volume>46</volume><issue>2</issue><spage>255</spage><epage>262</epage><pages>255-262</pages><issn>0301-0449</issn><eissn>1432-1998</eissn><abstract>Background
Our understanding of osseous morphology and pathology of the patellofemoral joint continues to improve with the use of magnetic resonance imaging (MRI), but a paucity of data currently exists in the pediatric population.
Objective
We aim to formulate a reproducible means of quantitative assessment of patellofemoral morphology in children using MRI and to describe morphological changes based on sex and age.
Materials and methods
We identified 414 children presenting between 2002 and 2014 who obtained a knee MRI to evaluate for knee pain or clinically suspected knee pathology. After application of inclusion criteria, 144 “normal” MRIs in 131 children (71 boys, 60 girls) were included in the analysis. The following MRI measurements were recorded: lateral trochlear inclination, trochlear facet asymmetry, trochlear depth, tibial tuberosity-trochlear groove distance, sulcus angle and patellar height ratio. To assess intraobserver reliability, measurements in 30 randomly selected children were repeated. Differences between patient age and sex were assessed using independent
t
-tests and adjusted regression analysis.
Results
All recorded measurements had strong to very strong inter- and intraobserver reliability: lateral trochlear inclination (0.91/0.82), trochlear facet asymmetry (0.81/0.83), trochlear depth (0.83/0.90), tibial tuberosity-trochlear groove distance (0.97/0.87), sulcus angle (0.84/0.78) and patellar height ratio (0.96/0.83). When age and sex were mutually adjusted, statistically significant differences between males and females were observed in trochlear depth (
P
= 0.0084) and patellar height ratio (
P
= 0.0035). However, statistically significant age differences were found on all measurements except for lateral trochlear inclination. As expected, mean measurement values approached adult norms throughout skeletal maturation suggestive of age-dependent patellofemoral maturation.
Conclusion
Our data verify the development of patellofemoral morphology with advancing age. We found that six of the most commonly used patellofemoral measurements in adults can be accurately reproduced regardless of age.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>26381426</pmid><doi>10.1007/s00247-015-3459-9</doi><tpages>8</tpages></addata></record> |
| fulltext | fulltext |
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| ispartof | Pediatric radiology, 2016-02, Vol.46 (2), p.255-262 |
| issn | 0301-0449 1432-1998 |
| language | eng |
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| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Adolescent Aging - pathology Anatomic Landmarks - pathology Child Child, Preschool Female Humans Imaging Infant Infant, Newborn Magnetic Resonance Imaging - standards Male Medicine Medicine & Public Health Neuroradiology Nuclear Medicine Observer Variation Oncology Original Article Patellofemoral Joint - pathology Pediatrics Practice Guidelines as Topic Radiology Radiology - standards Reference Values Reproducibility of Results Sensitivity and Specificity Ultrasound |
| title | Standardization of patellofemoral morphology in the pediatric knee |
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