Patello-Femoral Pain Syndrome: Magnetic Resonance Imaging versus Ultrasound

Patrizia Pacini; Milvia Martino; Luca Giuliani; Gabriele Santilli; Francesco Agostini; Giovanni Del Gaudio; Andrea Bernetti; Massimiliano Mangone; Marco Paoloni; Martina Toscano; Corrado De Vito; Carlo Ottonello; Valter Santilli; Vito Cantisani

doi:10.3390/diagnostics13081496

Patello-Femoral Pain Syndrome: Magnetic Resonance Imaging versus Ultrasound

Diagnostics (Basel). 2023 Apr 21;13(8):1496. doi: 10.3390/diagnostics13081496.

Affiliations

¹ Policlinico Umberto I Hospital, Department of Radiological and Oncological Sciences and Pathological Anatomy, Sapienza University, Policlinico Avenue 155, 00161 Rome, Italy.
² San Salvatore Hospital, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Vetoio Stree, 67100 L'Aquila, Italy.
³ Policlinico Umberto I Hospital, Department of Anatomical, Histological and Legal Medical Sciences and of Locomotor System, Sapienza University, Aldo Moro Square 3, 00185 Rome, Italy.
⁴ Fisiocard Medical Centre, Via Francesco Tovaglieri 17, 00155 Rome, Italy.

Abstract

Background: Magnetic Resonance Imaging (MRI) and Ultrasound (US) in combination with clinical data could contribute to the diagnosis, staging and follow-up of Patello-Femoral Syndrome (PFS), which often overlaps with other pathologies of the knee.

Purpose of the study: To evaluate the diagnostic role of MRI and US findings associated with PFS and define the range values of instrumental measurements obtained in pathological cases and healthy controls, the performance of the two methods in comparison, and the correlation with clinical data.

Materials and methods: 100 subjects were examined: 60 patients with a high suspicion of PFS at the clinical evaluation and 40 healthy controls. All measurements obtained by MRI and US examination were correlated with clinical data. A descriptive analysis of all measurements was stratified for pathological cases and healthy controls. A Student's t-test for continuous variables was used to compare patients to controls and US to MRI. Logistic regression analysis was applied to test the correlation between MRI and US measurements with clinical data.

Results: Statistical descriptive analysis determined the MRI and US range values of medial patello-femoral distance and the thickness of retinacles and cartilages in pathological cases and healthy controls. In pathological cases, the retinacle results of both increased; the medial appeared to be slightly more increased than the lateral. Furthermore, in some cases, the thickness of the cartilage decreased in both techniques; the medial cartilage was more thinned than the lateral. According to logistic regression analyses, the best diagnostic parameter was the medial patello-femoral distance due to the overlapping results of the US and MRI. Furthermore, all clinical data obtained by different tests showed a good correlation with patello-femoral distance. In particular, the correlation between medial patello-femoral distance and the VAS score is direct and equal to 97-99%, which is statistically significant (p < 0.001), and the correlation with the KOOS score is inverse and equal to 96-98%, which is statistically significant.

Conclusions: MRI and Ultrasound examination in combination with clinical data demonstrated high-value results in the diagnosis of PFS.

Keywords: MRI; PFPS; US.

Grants and funding

This research received no external funding.