Is Impingement the Cause of Jumper's Knee?: Dynamic and Static Magnetic Resonance Imaging of Patellar Tendinitis in an Open-Configuration System

Background Chronic overload is considered the main cause of patellar tendinitis, but it has been postulated that impingement of the inferior patellar pole against the patellar tendon during knee flexion could be responsible. Hypothesis The role of the patellar pole in patellar tendinitis can be dete...

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Bibliographic Details
Published in:The American journal of sports medicine 2002-05, Vol.30 (3), p.388-395
Main Authors: Schmid, Marius R., Hodler, Juerg, Cathrein, Philipp, Duewell, Stefan, Jacob, Hilaire A. C., Romero, José
Format: Article
Language:English
Subjects:
Adult
Athletic Injuries - etiology
Biological and medical sciences
Case-Control Studies
Causes of
Female
Humans
Injuries
Investigative techniques, diagnostic techniques (general aspects)
Knee
Knee injuries
Magnetic Resonance Imaging - methods
Male
Medical imaging
Medical sciences
Middle Aged
Muscle, Skeletal - physiology
Osteoarticular system. Muscles
Patella - anatomy & histology
Patella - pathology
Radiodiagnosis. Nmr imagery. Nmr spectrometry
Reference Values
Running - injuries
Sports injuries
Sports medicine
Tendinitis
Tendinopathy - etiology
Tendons
Tendons - anatomy & histology
Tendons - pathology
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Summary:Background Chronic overload is considered the main cause of patellar tendinitis, but it has been postulated that impingement of the inferior patellar pole against the patellar tendon during knee flexion could be responsible. Hypothesis The role of the patellar pole in patellar tendinitis can be determined by dynamic magnetic resonance imaging. Study Design Case-control study. Methods We compared 19 knees with patellar tendinitis and 32 asymptomatic knees of age-matched subjects using an open-configuration magnetic resonance imaging system. Dynamic sagittal images were obtained from full extension to 100° of flexion with and without activation of the quadriceps muscle. The following measurements were made from the images: tendon-patella angle, anteroposterior diameter of the tendon, signal difference-to-noise ratio, the shape of the inferior patellar pole, and the location of the patellar tendon insertion. Results The tendon-patella angle was not significantly different between groups at any flexion angle, with or without quadriceps muscle activation. The insertion site of the patellar tendon differed significantly but not the shape of the inferior pole of the patella. The volume and the signal difference-to-noise ratio of zones of increased intratendinous signal as well as the anteroposterior diameter of the proximal patellar tendon were increased in symptomatic knees. Conclusions The relationship between the patella and the patellar tendon was identical in both groups; therefore, chronic overload seems to be a major cause of patellar tendinitis.
ISSN:0363-5465
1552-3365
DOI:10.1177/03635465020300031401