Bone bruise in acute traumatic patellar dislocation: volumetric magnetic resonance imaging analysis with follow-up mean of 12 months

• Published in: Skeletal radiology Vol. 39; no. 7; pp. 675 - 682
• Main Authors: Paakkala, Antti, Sillanpää, Petri, Huhtala, Heini, Paakkala, Timo, Mäenpää, Heikki
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer-Verlag 01.07.2010; Springer; Springer Nature B.V
• Subjects: Acute Disease; Adult; Biological and medical sciences; Bone Diseases - diagnosis; Bone Diseases - etiology; Contusions - diagnosis; Contusions - etiology; Female; Follow-Up Studies; Humans; Image Enhancement - methods; Image Interpretation, Computer-Assisted - methods; Imaging; Imaging, Three-Dimensional - methods; Injuries of the limb. Injuries of the spine; Investigative techniques, diagnostic techniques (general aspects); Knee Injuries - complications; Knee Injuries - diagnosis; Magnetic resonance imaging; Magnetic Resonance Imaging - methods; Male; Medical research; Medical sciences; Medicine; Medicine & Public Health; Medicine, Experimental; Middle Aged; Nuclear Medicine; Orthopedics; Osteoarticular system. Muscles; Patellar Dislocation - complications; Patellar Dislocation - diagnosis; Pathology; Radiodiagnosis. Nmr imagery. Nmr spectrometry; Radiology; Reproducibility of Results; Scientific Article; Sensitivity and Specificity; Traumas. Diseases due to physical agents; Young Adult; Knee; Acute traumatic patellar dislocation; MRI; Bone bruise; Nuclear medicine; Volumetric analysis; Acute; Ecchymosis; Nuclear magnetic resonance imaging; Trauma; Patella; Orthopedics; Medical imagery; Bone
• ISSN: 0364-2348; 1432-2161
• DOI: 10.1007/s00256-009-0858-8

Objective The aim of the study was to assess volumetric analysis of bone bruises in acute primary traumatic patellar dislocation by magnetic resonance imaging (MRI) and resolving resolution of bruises in follow-up MRI. Materials and methods MRI was performed in 23 cases. A follow-up examination was done at a mean of 12 months after dislocation. Volumes of patellar and femur bruises for every patient were evaluated separately by two musculoskeletal radiologists, and mean values of the bruises were assessed. Other MRI findings were evaluated, together with agreement by consensus. Bone bruise volumes were compared with other MR findings. Results In the acute study 100% of patients showed bruising of the lateral femoral condyle and 96% bruising of the patella. The bruise was located at the medial femoral condyle in 30% and at the patellar median ridge in 74% of patients. The median volume of the femoral bruise was 25,831 mm 3 and of the patellar bruise 2,832 mm 3 . At the follow-up study 22% of patients showed bruising of the lateral femoral condyle and 39% bruising of the patella, the median volumes of the bruises being 5,062 mm 3 and 1,380 mm 3 , respectively. Larger patellar bruise volume correlated with larger femur bruise volume in the acute (r = 0.389, P  = 0.074) and the follow-up (r = 1.000, P  < 0.01) studies. Other MRI findings did not correlate significantly with bone bruise volumes. Conclusion Bone bruising is the commonest finding in cases of acute patellar dislocation, being seen even 1 year after trauma and indicating significant bone trabecular injury in the patellofemoral joint. A large bruise volume may be associated with subsequent chondral lesion progression at the patella. We concluded that the measurement of bone bruise volume in patients with acute patellar dislocation is a reproducible method but requires further studies to evaluate its clinical use.