Lateral patellar retinaculum tear radiology. patellar bonebruise or fracture.

Lateral patellar retinaculum tear radiology 1 Pain is often described as medial because of soft tissue injuries that occur to the medial retinaculum and/or MPFL. 10. MATERIALS AND METHODS: A computer search of all MR examinations of the knee with a coded diagnosis of patellar dislocation performed between February 1988 and October 1990 disclosed 22 cases (11 male and 11 female patients, aged 1-70 years). MRI is becoming an increasingly important diagnostic tool in assessment of traumatic patellar dislocations, useful in both detecting associated cartilage and soft tissue Aug 23, 2022 · The medial patellofemoral ligament (MPFL) belongs to the anterior medial supporting structures of the knee 1-3 and it is the main structure, preventing the patella from lateral displacement at 50-60% restraining force 1,7-9. All those patients were treated by the same experienced senior orthopaedic Diagnosis: O’Donoghue’s unhappy tetrad. Mar 16, 2023 · It is an important stabiliser of the patella, through this firm medial tibial condyle attachment and resists lateral patellar dislocation 1,2,3. Mar 27, 2021 · The superior peroneal retinaculum inserts at the lateral malleolus and extends to the lateral aspect of the calcaneus and the deep fascia of the leg 1. Gross anatomy. edema/hemorrhage of vastus medialis muscle. There is also almost complete/complete tear of medial patellofemoral retinaculum involving its patellar insertion. action: extends the leg at the knee joint. This may occur in isolation or in conjunction with anterolateral ankle instability. Failure to identify or treat injury to the patellar retinaculum is associated with recurrent patellar instability and contributes to significant morbidity. Epidemiology. Mar 21, 2024 · There is broad differential for cyst-like lesions around the knee. The fibrous capsule also has a deep component with thickening on the medial aspect being part of the medial collateral ligament. The medial supporting structures are the most commonly injured ligaments in the knee. Transient lateral patellar dislocation is a common injury that typically occurs in the young, athletic individual. Eleven gave a history of recurrent patellar dislocation. Aug 12, 2024 · Epidemiology. Feb 22, 2018 · Zhang GY, Zheng L, Shi H, Qu SH, Ding HY. (b) Shows complete lateral patellar retinaculum and iliotibial band tear (orange arrow) with capsular disruption (orange star). Failure to identify or treat injury to any of the patellar retinaculae is associated with recurrent patellar instability and contributes to significant morbidity. 30 Correctly diagnosing APD can be difficult as the displaced patella usually relocates spontaneously, with fewer than 10% of patients presenting with fixed lateral dislocation. The medial patellar retinaculum is often partially or completely torn in lateral patellar dislocation 4. Superiorly, it splits to enclose and anchor the aponeurosis of tensor fasciae latae and posteriorly most of the tendon of gluteus maximus 1. Injuries to the lateral retinaculum are best visualized by MRI, which may demonstrate disruption of a component ligament, periligamentous edema Dec 30, 2024 · Patellar instability is a condition characterized by patellar subluxation or dislocation episodes as a result of injury, ligamentous laxity or increased Q angle of the knee. Jan 19, 2022 · The lateral retinaculum was easily separated from the deep layers along all of the patellar margin with the exception of the triangular part with sides along the medial margin of the lateral femoral condyle (similarly to what was described for the medial compartment), the lateral margin of patellar ligament and the lateral tibial plateau. 4. In addition, we suspect that a focal defect can be a route of infrapatellar fat herniation and a route of superficial ex … medial patellofemoral ligament injury with a patellar avulsion fracture and a tear of the femoral origin; bone bruises at the typical locations at the inferomedial patella and the anterolateral margin of the lateral femoral condyle; a tear of the medial retinaculum; a myotendinous tear of the vastus medialis oblique (VMO) muscle May 29, 2024 · MRI. These fibers pass anteriorly to insert into the patella and patellar tendon. doi: 10. 4 However, several complications have been reported in the literature since then, including medial instability, quadriceps weakness, quadriceps atrophy, pain, and lateral patellar instability. If the patella continues to dislocate multiple times, reconstruction of the MPFL is performed with allograft, or a medial plication can be performed. 1 ± 18. lateral: lateral patellar retinaculum. Both MRI and ultrasound are accurate imaging modalities in the detection of MPFL injuries [5, 50, 51]. Given this A 25-year-old woman with anterolateral knee pain. (a) Axial T 1 W image showing vastus medialis atrophy (arrow), (b) Axial T 2 W fat suppressed image showing MPFL tear from the patella (arrow), (c) Axial T 2 W image showing MPFL tear from femur (arrow), (d) Axial T 1 W image showing subacute MPFL tear with haematoma. extensor mechanism of the knee injuries Sep 5, 2020 · The medial patellofemoral ligament (MPFL) is frequently torn and attenuated in patients with acute or chronic patellar instability. 7759 Dec 1, 1993 · PURPOSE: To illustrate the constellation of magnetic resonance (MR) findings that suggest prior patellar dislocation. Mar 6, 2019 · A prominent joint recess, the suprapatellar recess or pouch, extends superiorly from the knee joint between the patella and the femur and communicates with the medial and lateral joint recesses, which extend over the medial and lateral aspects of the femoral condyles beneath the patellar retinaculum ( Fig. QuinnSF. The content of lateral patellar retinaculum (LPR) release is to release relatively tight lateral structures that can laterally pull the patella for balancing the patella in the trochlear groove. • Injury to the MPFL is a common knee Injury to the MPFL is a common knee injury in children accounting for 9injury in children accounting for 9-16% of 16% of pediatric knee injuries. Magnetic Resonance Imaging Features of Traumatic Patellofemoral Dislocation. Apr 4, 2024 · Mainly occurs in preschool-aged and young children as a painless soft mass along the anterolateral aspect of knee joint due to a focal defect in the lateral retinaculum. Keywords Patellar retinaculum. We describe the clinical, ultrasound (US), and magnetic resonance (MR) imaging features of a transient medial patellar dislocation in a 19-year-old patient with t … Oct 26, 2023 · MRI may demonstrate tears of the medial patellofemoral ligament at the femoral attachment, rupture of the medial patellar retinaculum, subchondral impaction fractures, and bone contusions along the medial patellar facet and lateral femoral condyle, a large joint effusion, edema, and strains of the vastus medialis muscle (Fig. The abnormal patellar position, medial retinacular injury Dec 3, 2021 · suprapatellar plica / superior patellar plica; infrapatellar plica / ligamentum mucosum: most common knee plica; lateral patellar plica: rare (<1%) They range in shape from a ridge or shelf to more discrete cord-like structure 3. See also Mar 16, 2023 · The lateral patellar retinaculum is a fibrous expansion comprising of superficial and deep layers. There are As previously mentioned, injury patterns have been identified and categorized into 4 types based on MRI findings: injuries located at the patellar insertion, within the mid-substance, at the femoral origin or injury in multiple locations. A focal defect of the lateral patellar retinaculum was not found to be Dec 31, 2024 · Lateral Patellar Compression Syndrome is one condition linked with lateral patellar retinaculum tightness, characterized by improper tracking of the patella within the trochlear groove. Aug 23, 2022 · The medial patellofemoral ligament (MPFL) belongs to the anterior medial supporting structures of the knee 1-3 and it is the main structure, preventing the patella from lateral displacement at 50-60% restraining force 1,7-9. ajoint effusion isuni-versally seen18-141. , 2009), so it could be Sep 14, 2023 · Objective To compare MRI features of medial and lateral patellar stabilizers in patients with and without patellar instability. High-res … A focal defect of the lateral patellar retinaculum was not found to be a rare finding on knee MRI (frequency, 26%), and it may be a normal variant rather than a pathologic change. 16 MRI appears to be more accurate than arthroscopy in identifying femoral disruption of the MPFL and has Mar 24, 2023 · medial border of patella. Diagnosis is made clinically in the acute setting with a patellar dislocation with a traumatic knee effusion and in chronic settings with passive patellar translation and a Aug 1, 2003 · Because the quadriceps is relaxed, MRI of the resting knee can underestimate tilt and lateral displacement. medial patellofemoral ligament tear. It is one of the medial patellar stabilisers together with the medial retinaculum and the vastus medialis oblique muscle 5. twisting injury to flexed knee; contusion pattern: anterolateral lateral femoral condyle and inferomedial patella; associated with medial patellar retinaculum +/- medial patellofemoral ligament injury +/- medial patellotibial From MRI of knee joint , eight patients had only injured the medial patellar retinaculum near the patella, one patient had only a femoral attachment injury and the others had injury to both femoral attachment and patella attachment of the medial patellar retinaculum. Demlow TA. Differential diagnosis Cysts synovial cyst popliteal synovial cyst - Baker cyst ganglion cyst intra-articular ganglion cyst ACL ganglion cyst PCL ganglion cyst Hoffa fat Jan 19, 2022 · Radiological study: (a) MRI with MPFL, medial retinaculum, LPFL, lateral retinaculum indicated; ( b ) measurement of the medial retinaculum; ( c ) measurement of the medial patellofem- oral ligament. 3 The medial patellotibial ligament is torn in patellar-based medial retinacular injuries, based on MRI injury location. A focal lobulated mass with signal characteristics of fluid or cystic change can sometimes be present in the lateral soft tissues of the knee between the lateral femoral condyle and the lateral retinaculum. MRI Lateral Patellar Compression Syndrome is one condition linked with lateral patellar retinaculum tightness, characterized by improper tracking of the patella within the trochlear groove. Acute lateral patellar dislocation at MR imaging: injury patterns of medial patellar soft-tissue restraints and osteochondral injuries of the inferomedial patella. Middleton KK, Gruber S, Shubin Stein BE. Arterial supply. A retrospective review of an orthopedic database including more than 30 million Oct 1, 2000 · Finally, lateral patellar dislocation results in edema involving the inferomedial patella and anterior aspect of the lateral femoral condyle. The reported incidence is between 3-94% in patient population. Oct 4, 2024 · Patellar tendon rupture is one of the extensor mechanism of the knee injuries and occurs almost invariably at either the patellar or tibial insertion of the patellar tendon, when in the setting of trauma, and is often associated with a small avulsion fracture. Lateral patellar retinaculum is intact. The typical injury pattern is a tear of the medial patellofemoral ligament (MPFL) and bone bruises of the patella and the lateral femoral condyle. Radiology 2002; 225: 736-743. Courtesy of Daniel Bodor, MD, Radsource. Ellas et al. MRI does not accurately differentiate between partial or complete ACL tear. Also notice the hypertrophy of the SL fat pad extending far beyond the lateral retinaculum and causing anterior bowing of the patellar tendon (small arrows) Oct 1, 1993 · Injury of the medial patellar retinaculum was seen at MR in each case. Kirsch et al. Most medial knee injuries are isolated and occur in young active patients participating in sports. The Saupe classification describes the bipartite patella according to the location of the secondary ossification center 2: type I: inferior pole ~1%. 17,18 The superficial layer is composed of oblique fibers of the lateral retinaculum originating from the iliotibial band and the vastus lateralis fascia and inserting into the lateral margin of the Mar 26, 2019 · The lateral patellar retinaculum (LPR) is a complex structure that acts as a passive stabilizer of the femoropatellar joint. FIGURE 3. But yes we can differentiate between high grade or low grade injury. Medial patellofemoral ligament. medial patellar retinaculum. MPFL, medial The lateral patellar retinaculum is injured more often than the medial patellar retinaculum, and may occur by direct trauma, medial patellar subluxation, or tibiofemoral translation (i. Lateral patellar retinaculum. Finally, it should be noted that the avulsed medial patellar fracture fragment is not mobile and usually stays in one position. All five specimens The lateral patellar retinaculum is a fibrous expansion comprising of superficial and deeper layers. Jul 20, 2024 · inferior: patellar tendon, infrapatellar bursa, infrapatellar fat pad. Axial, proton density–weighted, fat-suppressed Apr 4, 2024 · Mainly occurs in preschool-aged and young children as a painless soft mass along the anterolateral aspect of knee joint due to a focal defect in the lateral retinaculum. Feb 21, 2009 · Medial dislocation of the patella is an unusual entity. CONCLUSION: Constant findings at MR imaging were (a) contusion of the lateral femoral condyle, (b) tear of the medial retinaculum, and (c) joint effusion. MRI of vastus medialis and patellar retinaculum pathologies. This syndrome results in typically dull aching pain and can significantly affect athletic performance. An important injury that may have a similar clinical presentation and is often misdiagnosed as “ankle sprain” is that of peroneal tendon dislocation with injury of the superior peroneal retinaculum. 1F ). The inferior peroneal retinaculum is a continuation of the inferior extensor retinaculum of the foot, extending posteriorly and laterally to attach to the lateral aspect of the calcaneus 1. This article will help the reader become familiar with normal imaging findings and the most commonly occurring injuries/pathologies in MPR and LPR. medial: medial patellar retinaculum. Sonography on injury of the medial patellofemoral ligament after acute traumatic lateral patellar dislocation: injury patterns and correlation analysis with injury of articular cartilage of the inferomedial patella. A bucket handle tear of the lateral meniscus with a medially flipped fragment is visible. innervation: femoral nerve (L2 - L4) Gross anatomy. Gross anatomy The superficial layer originates from the lowest fibers of the iliotibial band and from an extension of vastus lateralis fascia. It is usually treated with rest and physical therapy. Cureus. RESULTS: Eighteen cases (82% Elias DA, White LM, Fithian DC. Oct 25, 2024 · suture the patellar tendon to the patella with a #5 non-absorbable transosseous suture drill 2 trans-patellar bony tunnels and pass the sutures through tunnels and tie over the top of patella can be protected with a cerclage wire or nonabsorbable tape between patella and tibial tuberosity Nov 7, 2022 · associated with ACL, PCL, meniscal injuries, and in severe cases knee dislocation; lateral patellar dislocation. quadriceps tendon. Inclusion criteria were a history and physical exam consistent with primary LPD, and Acute patellar dislocation (APD) is a common injury in children, accounting for up to 16% of acute knee hemarthroses. JMagzRcsoi: Imagi,zg 1993:3: The lateral retinaculum is a richly innervated connective tissue structure located on the lateral aspect of the knee. 7 Associated with the lateral retinaculum are multiple distinct bundles of connective tissue forming three ligaments: the patellar portion of the ITB, the LPFL, and the lateral patellotibial ligament. tibial tuberosity. 1 Knowledge of the anatomy and patterns of injury of these structures is crucial for early and correct diagnosis by clinical examination and magnetic Skeletal Radiology, 2019, 48 (11), pp. The ITB is a thickening in the fascia lata. bone contusions or cartilage injuries of the medial patella facet and lateral femoral condyle. CONCLUSION. The mainstay for surgical treatment has become MPFL reconstruction to reestablish the checkrein to lateral patellar translation. A high grade injury is 'not able to see 50% of the fibers'. Injury 2013;44:1892–1898. The lateral patellofemoral retinaculum (LPR) was evaluated for injury and thickness on the axial T2 fat-saturated images, with the area of maximal thickness measured. Most commonly, it is at the superior attachment to the inferior pole of the patella Aug 7, 2016 · With MR imaging the retinacular injury, the avulsed bony fragment, and bone bruises involving the medial margin of the patella and lateral femoral condyle are readily demonstrable (Fig. Stressing onthehuman fem-oro-patellar joint. patellar bonebruise or fracture. MATERIALS AND METHODS. Pathology. In the acute and subacute setting MRI displays features of lateral patellar dislocation as: knee joint effusion. 7 The patellar Mohan K, Ellanti P, Lincoln M, McCarthy T. In the sagittal plane, the Jan 15, 2019 · Patellofemoral pain syndrome (PFPS) is a common cause of knee pain in adolescents and adults younger than 60 years. 4 It is composed of 2 layers. 9, 11, 38, 40, 41, 42 . May 16, 2024 · patellar retinaculum and tibial tuberosity anteriorly; head of the fibula laterally; There is also an aperture for the popliteus tendon at the lateral tibial condyle. Associated findings of lateral patellar subluxation (6a) and/or patella alta are frequently present. Jul 27, 2024 · The extensor mechanism of the knee comprises: quadriceps muscle. Pathology The lateral patellar retinaculum is less commonly injured than the medial patellar retinaculum, however it is often disrupted during surgery to correct abnormal lateral patellar Feb 15, 2017 · OBJECTIVE. Inallseries. Arterial blood enters via the anterior surface of the patella and an anastomotic patella ring is formed supplied by the Jul 4, 2010 · First-time patellar dislocation typically occurs with twisting knee motions, during which the medial ligamentous stabilizers rupture, and the patella strikes against the lateral femoral condyle. INTRODUCTION Transient lateral patellar dislocation is an injury that occurs in recreational and high-performance athletes. Mar 29, 2022 · Excessive lateral pressure syndrome is due to an imbalance between medial and lateral dynamic stabilizers, either secondary to a shortened lateral retinaculum/vastus lateralis (more common) or a lax medial retinaculum/vastus medialis. The typical MRI findings after transient lateral dislocation of the patella have been well described and include a bone contusion pattern involving the inferomedial pole of the patella and the anterolateral aspect of the nonarticular portion of the lateral femoral condyle. 12,18–20,22 Most commonly, this has been reported as an iatrogenic consequence of lateral retinacular release, which inadvertently transects the ligamentous structures, at least of the deep layers. US showed acute injury to the lateral In one MRI study, 76% of cases of prior lateral patellar dislocation showed medial retinacular injury at its patellar insertion and 30% at its midsubstance, and injury of the femoral origin of the MPFL was identified in 49% of the cases . type II: lateral margin ~20-25% Feb 28, 2017 · Purpose The primary goal was to describe the injury patterns in a population of primary (first time) lateral patellar dislocators (LPD) to lend clarity to commonly held notions about injury patterns in this population. Medial patellar instability is a recognized problem in patients with anterior knee pain. , 2006), and it has been shown recently that the transverse ITB–patellar band is slack when the knee is extended and tightens significantly in flexion (Ghosh et al. 12b–d). It is more commonly injured than the lateral patellar retinaculum. 7,12 Kaplan 10 first described the anatomic Dec 14, 2018 · Traumatic patellar dislocations most commonly occur laterally and are associated with injury to both the medial patellofemoral ligament and medial patellar retinaculum. We describe the clinical, ultrasound (US), and magnetic resonance (MR) imaging features of a transient medial patellar dislocation in a 19-year-old patient with trochlear groove dysplasia presenting no surgical history. patella. Two radiologists independently reviewed 99 knee MR images for the presence of a focal defect at the lateral patellar retinaculum and Feb 15, 2017 · OBJECTIVE. Three knees were injected with gelatin gadolinium solution before imaging. Acute patellar dislocation leadstoawell-documented constellation ofMR findings. Feb 15, 2017 · OBJECTIVE. May 26, 2024 · A cystic lesion can sometimes be found between the lateral femoral condyle and the lateral retinaculum. We do know that the lateral retinacular structures help to resist patellar lateral subluxation when the knee is near extension (Christoforakis et al. Jun 14, 2019 · In one MRI study, 76% of cases of prior lateral patellar dislocation showed medial retinacular injury at its patellar insertion and 30% at its midsubstance, and injury of the femoral origin of the MPFL was identified in 49% of the cases . Diagnosis is made clinically with pain with compression of the patella and moderate lateral facet tenderness and sunrise knee radiographs will often show patellar tilt in the lateral direction. The patellar dislocations were clinically unsuspected in the initial evaluation of eight of these nine patients. Th Mar 16, 2023 · It is an important stabilizer of the patella, through this firm medial tibial condyle attachment and resists lateral patellar dislocation 1,2,3. 40,41,45,46 These include joint effusions, injuries to the medial retinaculum, and contusion or osteochondral injury of the anterolateral portion of the lateral femoral condyle and of the Mar 20, 2024 · Lateral and medial retinaculum represent complex structures that need to operate in a symmetrical manner to equalize patellofemoral contact mechanics []. Acute lateral patellar dislocation at MR imaging: injury patterns of medial patellar soft-tissue restraints and osteochondral injuries of the inferomedial patella Radiology . Anatomically, the LPR is a two-layered fibrous structure with a superficial layer attached medially to the patella and patellar tendon and extending laterally to the iliotibial band, and a deep layer that consists in the craniocaudal direction, of the lateral Dec 1, 2002 · Incidence of second-time lateral patellar dislocation is associated with anatomic factors, age and injury patterns of medial patellofemoral ligament in first-time lateral patellar dislocation: a prospective magnetic resonance imaging study with 5-year follow-up Aug 18, 2023 · lateral displacement of patella (not necessarily seen in transient dislocation) medial patellar contusion +/- corresponding lateral femoral condyle contusion; joint effusion; The presence of an abnormal medial patellar retinaculum should suggest the diagnosis of transient lateral patellar dislocation 1. MATERIALS AND METHODS: Knee MR images obtained within 8 weeks after LPD were evaluated for medial retinacular and medial patellofemoral ligament (MPFL) disruption, vastus medialis Mar 11, 2020 · Axial PD FS image shows the cyst bulging anteriorly into the Hoffa’s fat pad. 225, No. Oct 4, 2023 · Lateral retinacular release was first described by Merchant and Mercer in 1974 as a simple, low-risk procedure to address patellar pain and instability. The quadriceps muscles pull the patella obliquely and laterally in relation to the femur. May be seen as a shelf like band. Nov 1, 2022 · Objective The purpose of this study was to assess the frequency and MRI features of a subcutaneous anterior knee mass herniated from the infrapatellar fat pad (IPFP) through a focal defect of the patellar retinaculum (PR). 2253011578. The superficial fibers of the lateral patellar retinaculum originate from the iliotibial band and from the vastus lateralis fascia. MRI Medial dislocation of the patella is an unusual entity. Introduction: Acute lateral patellar dislocation is a very common condition in orthopedics, especially among adolescents and physically active patients. Jan 8, 2025 · Lateral Patellar Compression Syndrome is one condition linked with lateral patellar retinaculum tightness, characterized by improper tracking of the patella within the trochlear groove. The above video demonstrates the mechanism of injury in patellar dislocation. Compared to a proximal or distal patellar tendon rupture, midsubstance tears rely on tendon-to-tendon healing instead of bone to tendon healing. Anat Emb’ol (Be,!)1983:168:117-123 2. anterior: prepatellar bursa. In many instances, the mechanism of injury can be determined by studying the distribution of bone marrow edema, which then enables one to predict with accuracy the specific soft-tissue abnormalities that The lateral retinaculum is composed of a dense connective tissue sheath that forms the lateral portion of the joint capsule. Lateral subluxation of the patella was a common finding. 2018 Dec 14;10(12):e3730. also supported our data in a magnetic resonance imaging (MRI) study of 82 patients with the diagnosis of lateral patella dislocation and found that 76% of medial retinacular/MPFL disruption occurred at its patellar insertion site, 49% occurred at the femoral attachment site, 30% showed injury of the MPFL at mid-substance, and 48% had more than one site of injury []. The purpose of this study is to retrospectively investigate the frequency of a focal defect at the lateral patellar retinaculum on knee MRI and to determine the variables that are significantly associated with the defect. The injured retinaculum had an indistinct, irregular appearance associated with edema and hemorrhage. Axial, coronal, and sagittal images were reviewed for evidence of injury elsewhere in the knee, including collateral and cruciate The most common ankle injury is a lateral ligamentous sprain. See also Aug 18, 2023 · lateral displacement of patella (not necessarily seen in transient dislocation) medial patellar contusion +/- corresponding lateral femoral condyle contusion; joint effusion; The presence of an abnormal medial patellar retinaculum should suggest the diagnosis of transient lateral patellar dislocation 1. 7,14 While plain radiography is an important tool to diagnose APD, magnetic resonance imaging (MRI Axial PD FS MRI image demonstrates focal bone marrow edema involving the inferomedial aspect of the patella and the lateral aspect of the lateral femoral condyle, characteristic of prior lateral patellar dislocation injury. The lateral patellar retinaculum (LPR) is a complex structure showed prior evidence of knee injury or MRI can visualize the retinaculum and MPFL and help determine if there is a tear or an accompanying osteochondral fragment. CT. Associated findings include lateral patellar subluxation and patella alta, which are found in around 90% of cases 1,2. In the sagittal plane, the magnetic resonance image of the left knee, showing an avulsion of the lateral patellar retinacular sleeve from the lateral patella, with associated adjacent bone marrow and retinacular edema (blue arrow) and an edematous and thickened lateral patellofemoral ligament (orange arrow). Nov 7, 2022 · associated with ACL, PCL, meniscal injuries, and in severe cases knee dislocation; lateral patellar dislocation. 5 years; 119 women) after diagnosis of patellar instability (cohort-1, acute patellar dislocation; cohort-2, chronic patellar maltracking) or no patellar instability (cohort-3, acute ACL rupture; cohort —False-positive finding of type II superior peroneal retinacular injury in 28-year-old woman with pain along lateral malleolus suspected clinically to have superior retinacular injury. Like plain radiographs, CT can detect a bony avulsion injury as well as knee joint effusion and possibly concomitant osteochondral injuries. To evaluate distinct medial patellofemoral ligament (MPFL) injury patterns and the associated knee pathology after acute lateral patellar dislocation (ALPD) using magnetic resonance imaging (MRI) studies, which is essential for the development Dec 1, 2002 · PURPOSE: To assess magnetic resonance (MR) imaging findings after acute lateral patellar dislocation (LPD) with emphasis on the medial patella restraints and to describe a medial patellar impaction deformity. intra-articular fragments Imaging ofNormal Patellar Retinaculum AJR:168,June1997 1499 References I. Contusions ofthe lateral temoral condyle rangeinfrequency from31c Nov 13, 2024 · The iliotibial band (ITB) or tract is a thick band of fascia along the lateral aspect of the thigh. . twisting injury to flexed knee; contusion pattern: anterolateral lateral femoral condyle and inferomedial patella; associated with medial patellar retinaculum +/- medial patellofemoral ligament injury +/- medial patellotibial Jul 20, 2024 · The medial patellar retinaculum attaches to the vastus medialis / sartorius fascia and is often disrupted in lateral patellar dislocation. (femoral), midsubstance, or a combination. [Google Scholar] 87. Most commonly, it is at the superior attachment to the inferior pole of the patella May 26, 2024 · A cystic lesion can sometimes be found between the lateral femoral condyle and the lateral retinaculum. Methods Retrospective study of 196 patients (mean age, 33. patellar tendon. Tillmann B. It is one of the medial patellar stabilizers together with the medial retinaculum and the vastus medialis oblique muscle 5. A constellation of findings have been described at MRI, characteristic for previous lateral patellar dislocation, and which may be helpful diagnostically. evaluation of patellar retinaculum anatomy and pathology. arterial supply: femoral, deep femoral and superior medial genicular arteries. including lateral femoral condyle trabecular injury (bone bwise. Stabilizes patella medially. Methods A prospective study identifying patients presenting with LPD between 2008 and 2012. It is necessary to differentiate LPCS from other causes of patellofemoral pain. 7. The Jan 21, 2023 · The type and timing of treatment of a posterolateral corner injury depend on concomitant injuries, in particular, cruciate and meniscal injuries, the grade of injury, and individual level of physical activity 6: grades 1 and 2: usually respond well to conservative non-surgical treatment, which normally involves a hinged knee brace and physiotherapy Oct 4, 2024 · Patellar tendon rupture is one of the extensor mechanism of the knee injuries and occurs almost invariably at either the patellar or tibial insertion of the patellar tendon, when in the setting of trauma, and is often associated with a small avulsion fracture. It is located posterior to Hoffa's fat pad. Thickening and indistinctness of superior peroneal retinaculum are noted on axial T1-weighted image (TR/TE, 900/22) and were believed to be avulsion injury. 2002 Dec;225(3):736-43. 23: Ax PD FS images (a) with complete medial patellar retinaculum tear (red arrow) and capsular disruption (orange star). Materials and methods This study included 94 patients (44 men; age range, 1–80 years; mean age, 52 years) with clinically palpable subcutaneous anterior knee masses who Mar 6, 2019 · A prominent joint recess, the suprapatellar recess or pouch, extends superiorly from the knee joint between the patella and the femur and communicates with the medial and lateral joint recesses, which extend over the medial and lateral aspects of the femoral condyles beneath the patellar retinaculum ( Fig. 1148/radiol. Classification. MRimaging of patellar retinacular ligament injuries. All patients had a joint effusion. Two radiologists independently reviewed 99 knee MR images for the presence of a focal defect at the lateral patellar retinaculum and See full list on radiopaedia. Beyond that, they might show a sliver sign indicating a recent lateral patellar dislocation. The injury most Dec 3, 2021 · suprapatellar plica / superior patellar plica; infrapatellar plica / ligamentum mucosum: most common knee plica; lateral patellar plica: rare (<1%) They range in shape from a ridge or shelf to more discrete cord-like structure 3. Key words: sonography, knee, patellar retinaculum, vastus medialis obliquus, medial collateral ligament, patellar dislocation, bony avulsion, adductor tubercle. It may cause anterior knee pain, especially after trauma, sports injury, or overuse. Medial patellar retinaculum. Oct 20, 2024 · Only 2% of patients with bipartite patella experience symptoms. Five cadaveric knee specimens underwent sonography and MR imaging using the following sequences: T1-weighted axial, sagittal, coronal, and five oblique planes and axial three-dimensional gradient-echo imaging. 1753-1758. Radiographic features CT arthrography. A previous laboratory study has demonstrated that the synergism between lateral and medial retinaculum is crucial to ensure patellar stabilization and centralization of the patella in the trochlear groove []. Related pathology. Because of the transient and brief nature of lateral patellar dislocations, the diagnosis is frequently unrecognized by both patients and clinicians. Mar 18, 2023 · The transverse ligament of the knee, also called the transverse meniscal ligament (of Winslow) attaches transversely across the anterior horns of the medial and lateral menisci. andmedial retinacular injury 18-141 (Fig. It is usually an iatrogenic complication of surgical lateral retinacular release. Failure to identify or treat injury to the patellar AIM: To describe the sonographic appearances of the medial retinacular (MPFR) complex of the knee in patients with acute and recurrent patellar dislocation. Vastus medialis is described as having two components based on the origin/insertion and orientation of the muscle Oct 6, 2024 · MRI findings may reveal injuries to medial patellar stabilizers, such as the medial patellar retinaculum and the medial patellofemoral ligament (MPFL), which often correlate with prior lateral patellar dislocations . intra-articular fragments May 29, 2021 · Lateral patellar compression syndrome is the improper tracking of the patella in the trochlear groove generally caused by a tight lateral retinaculum. e. Gross anatomy The superficial layer originates from the lowest fibres of the iliotibial band and from an extension of vastus lateralis fascia. In eight of 17 patients, the mechanism of injury was a patellar tendon tear (n = 1) or valgus hyperextension (n = 7). Ten patients had examination under anaesthesia with The medial patellar retinaculum (MPR) and the lateral patellar retinaculum (LPR) are vital structures for the stability of the patella. If left untreated, these can be debilitating injuries for patients and leave them with an overall lack of function in the injured extremity. Two radiologists independently reviewed 99 knee MR images for the presence of a focal defect at the lateral patellar retinaculum and Aug 18, 2023 · lateral displacement of patella (not necessarily seen in transient dislocation) medial patellar contusion +/- corresponding lateral femoral condyle contusion; joint effusion; The presence of an abnormal medial patellar retinaculum should suggest the diagnosis of transient lateral patellar dislocation 1. 17) Ninety-six Jan 19, 2013 · Acute Lateral Patellar Dislocation at MR Imaging: Injury Patterns of Medial Patellar Soft-Tissue Restraints and Osteochondral Injuries of the Inferomedial Patella 1 Dec 2002 | Radiology, Vol. Vastus lateralis continues as lateral and medialis continues as medial retinaculum and these are often involved in patellar tendon rupture. Fig. MATERIALS AND METHODS: Thirty patients were scanned within 2–4 weeks of an acute episode of lateral patellar dislocation. ACL injury). Introduction. BlauthM. BrownTR. lateral patellar retinaculum. Midsubstance tears of the patellar tendon are uncommon and present a difficult injury to treat. Jul 4, 2010 · First-time patellar dislocation typically occurs with twisting knee motions, during which the medial ligamentous stabilizers rupture, and the patella strikes against the lateral femoral condyle. Th tellar fat pad area only. The medial patellofemoral ligament is almost always injured in acute first-time lateral patellar dislocations 1-3, less often in recurrent dislocations and may be injured in multi-ligament injuries of the knee 4, especially in those involving the medial collateral ligament. 5-13 A valid alternative to lateral retinacular Aug 12, 2024 · Epidemiology. • The MPFL is a primary constraint to lateral lateral subluxation subluxation and dislocation of the and dislocation of the patella. See also Aug 2, 2005 · Based on these images we cannot differentiate between complete tear, high grade partial tear or partial tear. There is also a partial tear of the lateral patellar retinaculum (orange arrow) with lateral femoral condyle contusion (red star) and fascial edema (blue arrow). Jun 1, 2011 · Rectus femoris fibres continue down the anterior aspect of patella as patellar tendon. In LPCS shortening and tightness of the lateral retinacular with an increased lateral patellar tilt as a result of hypertrophy of the lateral retinacular are present, without previous cartilage lesions or patellar instability . First-time patellar dislocation typically occurs with twisting knee motions, during which the medial ligamentous stabilizers rupture, and the patella strikes against the lateral femoral condyle. Components ofavertical and horizontal tensile bracing system. Medial patellomeniscal Dec 1, 2002 · Incidence of second-time lateral patellar dislocation is associated with anatomic factors, age and injury patterns of medial patellofemoral ligament in first-time lateral patellar dislocation: a prospective magnetic resonance imaging study with 5-year follow-up May 29, 2024 · MRI. High-resolution magnetic resonance imaging (MRI) readily depicts the detailed anatomy of various Mar 16, 2023 · The lateral patellar retinaculum is a fibrous expansion comprising of superficial and deep layers. The Mar 16, 2023 · It is an important stabilizer of the patella, through this firm medial tibial condyle attachment and resists lateral patellar dislocation 1,2,3. Nov 9, 2011 · The medial patellar retinaculum (MPR) and the lateral patellar retinaculum (LPR) are vital structures for the stability of the patella. Mar 16, 2023 · From this insertion, it extends posteriorly to blend with the lateral margin of the knee capsule and inferior surface of the lateral tibial condyle 1,2. Skeletal immaturity plays a role in the location of the injury pattern with isolated patellar-based MPFL/chondral injury being more common in the skeletally immature patient. 22: Complete tear of the medial patellar retinaculum with defect (white arrow) with retracted fibres in the patellofemoral compartment (yellow arrow). org Aug 12, 2024 · Plain radiographs might detect bony avulsion injuries and possibly lipohemarthrosis. The authors describe a technique for MPFL reconstruction with concomitant lateral retinacular lengthening with a gracilis allograft and The purpose of our study was to define retinacular anatomy with MR imaging and sonography. MRI is the modality of choice though high frequency USG would show acute tear as hypoechoic region in experienced hands. This results in a lateral tilt of the patella without lateral translation, subluxation or dislocation. Apr 13, 2021 · In general, patellar dislocation is diagnosed on imaging retrospectively due to indirect findings on MRI: disruption of the medial retinaculum and medial patellofemoral ligament, typical bone marrow edema on the medial aspect of the patella and the anterolateral aspect of the lateral femoral condyle, osteochondral injuries (especially at the Nonetheless, it was demonstrated that in patients with lateral patellar hyperpressure syndrome, evidenced by an increase in the patellar tilt observed at knee CT or at the test of medial patellar slide in extension, 40 a significant improvement in pain was observed in the short term after lateral retinacular release. 9 Since the isolated LPR release caused poor long-term results of RPD, the surgical procedure has no longer been considered as an isolated treatment Jun 1, 2023 · Although lateral retinacular structures are occasionally injured in the setting of trauma, these structures most commonly are clinically relevant when they are associated with fibrosis (decreased elasticity) or iatrogenic injury (eg, after aggressive lateral retinacular release or surgical overcorrection in patients with lateral patellar Oct 1, 1993 · Injury of the medial patellar retinaculum was seen at MR in each case. a Sagittal T2Wfs and b axial T2Wfs images demonstrate superolateral Hoffa's fat pad edema (large arrows). The medial patellar retinaculum (MPR) and the lateral patellar retinaculum (LPR) are vital structures for the stability of the patella. posterior: knee joint, femur. In all three cadaveric specimens, the lateral patellar retinaculum was more loose and sparse than the medial patellar retinaculum, and this site corresponded to the location of the defect on MRI. The lateral patellar retinaculum is attached to the fascia of vastus lateralis and iliotibial band 6. In one study utilizing MRI, the focal defect in the lateral patellar retinaculum was found with 26% frequency 2 . I. [25], demonstrated a distinctive constellation of MRI findings that can be used to distinguish transient lateral patellar subluxation from other common knee injuries. Bony contusions are seen on the contralateral femoral condyle (yellow star). wobskr bam iegcapeq wua yphfat caruj jsptf dkvwrh jno mpbir