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(Radiology. 2000;216:858-864.)
© RSNA, 2000

Musculoskeletal Imaging

Femoral Trochlear Dysplasia: MR Findings1

Christian W. A. Pfirrmann, MD, Marco Zanetti, MD, José Romero, MD and Juerg Hodler, MD

1 From the Departments of Radiology (C.W.A.P., M.Z., J.H.) and Orthopaedic Surgery (J.R.), Orthopaedic University Hospital, Forchstrasse 340, CH-8008 Zurich, Switzerland. Received July 14, 1999; revision requested August 25; final revision received December 10; accepted December 20. Address correspondence to C.W.A.P. (e-mail: pfirrm16@centralnet.ch).

PURPOSE: To establish quantitative and qualitative magnetic resonance (MR) criteria for the diagnosis of trochlear dysplasia.

MATERIALS AND METHODS: MR images were analyzed in 16 consecutive patients with and 23 without trochlear dysplasia. The standard of reference was a true lateral radiograph of the knee. Quantitative and qualitative MR criteria were assessed.

RESULTS: In patients with trochlear dysplasia, the trochlear groove was significantly less deep than that in control subjects. The most accurate measurement was 3 cm above the femorotibial joint space (P < .001), where a trochlear depth of 3 mm or less had a sensitivity of 100% and a specificity of 96%. The ventral trochlear prominence between the supratrochlear femoral cortex and the most ventral point of the trochlear floor (midsagittal section) was always larger than 6.9 mm in dysplastic trochleae. A facet ratio of less than 2:5 (medial to lateral) 3 cm above joint space level had a sensitivity of 100% and a specificity of 96%. A nipplelike anterior prominence at the superior end of the femoral trochlea on midsagittal images was a specific (91%) qualitative criterion.

CONCLUSION: Dysplasia of the femoral trochlea can be diagnosed reliably by using quantitative or qualitative criteria on midsagittal or transverse MR images obtained 3 cm above the femorotibial joint space.

Index terms: Femur, dysplasia, 451.14 • Knee, abnormalities, 45.78 • Knee, anatomy, 45.92 • Knee, MR, 45.121411, 45.121412




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