[An analysis of patellar cartilage perfusion by dynamic magnetic resonance: its application to subjects with anterior pain of patellar origin].

INTRODUCTION

Patellar chondromalacia is thought to be secondary to a change in vascularization of subchondral tissue, which could affect the deeper layers of the cartilage.

OBJECTIVE

To evaluate whether there are differences in joint cartilage perfusion and subchondral bone with dynamic studies of magnetic resonance (MR).

MATERIALS AND

METHODS

Seventeen consecutive patients were studied. Patients were divided into individuals with pain of likely femoropatellar origin (n = 11) and controls (n = 6) by means of dynamic MR after the administration of intravenous contrast. Parametric images were obtained by means of digital analysis of maximal uptake, mean uptake and maximal rate of contrast uptake in the joint cartilage and subchondral bone.

RESULTS

Uptake and maximal rate of cartilage, in its outer slope, were statistically higher for subjects with pain of likely femoropatellar origin than for controls (40.9 +/- 24.6 versus 23.3 +/- 4.6, p = 0.04, and 30.4 +/- 17.7 versus 17.4 +/- 2.6, p = 0.03, respectively). A higher perfusion of the cartilage was also observed in the qualitative analysis in patients with pain of likely femoropatellar origin (p = 0.009).

CONCLUSIONS

The different uptake observed in the patellar cartilage allows to suppose that in chondromalacia there are vascular changes in the deeper layers of joint cartilage, characterized by an increase in perfusion.