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Bildgebung der patellofemoralen Instabilität

Imaging of patellofemoral instability

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Zusammenfassung

Die patellofemorale Instabilität stellt aufgrund ihrer multifaktoriellen Genese eine diagnostische und therapeutische Herausforderung dar. Aufgabe der Bildgebung ist es, anlagebedingte Risikofaktoren wie Trochleadysplasie, Patellahochstand, Torsionsfehlstellungen der unteren Extremität, TTTG-Abstand und Patellatilt systematisch zu analysieren. Um die ätiologischen Faktoren mit einer ausreichenden diagnostischen Genauigkeit zu bewerten, sind standardisierte und umfangreich evaluierte Messverfahren sowie der gezielte Einsatz verschiedener bildgebender Modalitäten erforderlich.

Die Diagnose einer traumatischen, oftmals klinisch inapparenten Patellaluxation kann anhand der charakteristischen Befundkonstellation in der MRT gestellt werden. Der Schädigung des medialen patellofemoralen Ligaments (Elogantion/Ruptur) im Rahmen einer akuten Luxation wird, ähnlich wie den anlagebedingten Risikofaktoren, eine große Bedeutung im Hinblick auf die Entstehung einer chronischen Instabilität beigemessen.

Abstract

Patellofemoral instability remains a diagnostic and therapeutic challenge due to its multifactorial genesis. The purpose of imaging is to systematically analyze predisposing factors, such as trochlear dysplasia, patella alta, tibial tuberosity-trochlear groove (TT-TG) distance, rotational deformities of the lower limb and patellar tilt. In order to evaluate anatomical abnormalities with a sufficient diagnostic accuracy, standardized measurement methods and implementation of various imaging modalities are necessary.

Diagnosis of acute and often overlooked lateral patellar dislocation can be established with magnetic resonance imaging (MRI) because of its characteristic patterns of injury. Damage to the medial patellofemoral ligament (MPFL) has a significance just as high as the predisposing risk factors in relation to the cause of chronic instability.

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  1. Institut für diagnostische und interventionelle Radiologie, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, München, Deutschland

    S. Waldt & E. J. Rummeny

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  2. E. J. Rummeny
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Correspondence to S. Waldt.

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Waldt, S., Rummeny, E. Bildgebung der patellofemoralen Instabilität. Radiologe 52, 1003–1011 (2012). https://doi.org/10.1007/s00117-012-2367-3

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