Emerson Garms

Prevalence of Pain on Palpation of the Inferior Pole of the Patella Among Patients with Complaints of knee Pain

CONTEXT AND OBJECTIVE Patellar tendinopathy is a common condition in sports. It may occur at any location of the patellar tendon, but the most commonly affected area is the inferior pole of the patella. Among various diagnostic tests, the one most used is palpation of the inferior pole of the patella. The aim of this study was to investigate the prevalence of pain complaints among individuals with pathological knee conditions and to evaluate palpation of the inferior pole of the patella as a diagnostic test for patellar tendinopathy. METHODS Palpation of the patellar tendon was performed on 318 individuals who presented with knee-related complaints. Palpation was performed with the individual in the supine position and the knee extended. The age, gender, physical activity and labor activity of each individual were recorded at the time the symptoms appeared; the diagnosis was also recorded. RESULTS Of the total number of individuals evaluated, 124 (39%) felt pain on palpation of the inferior pole of the patella. Of these, only 40 (32.3%) received a diagnosis of patellar tendinopathy. We did not observe any difference with respect to gender and age distribution. When evaluating daily physical activity levels, however, we observed that individuals with pain on palpation of the inferior pole of the patella experienced more intense physical activity. CONCLUSIONS Palpation of the inferior pole of the patella is a diagnostic procedure with high sensitivity and moderate specificity for diagnosing patellar tendinopathy, especially among individuals who perform activities with high functional demands.

Avaliação quantitativa das forças laterais da patela: ressonância magnética estática e cinemática

OBJECTIVE: To evaluate the usefulness of combining static and kinematic magnetic resonance imaging in the evaluation of the femoropatellar joint. MATERIALS AND METHODS: Twenty healthy volunteers (40 knees) and 23 patients (43 knees) were submitted to both static and kinematic magnetic resonance imaging on a 1.5 tesla whole-body magnetic resonance scanner. The knees were positioned at 30o flexion with the quadrature knee coil at the inner end of the examination table. The patellar translation was evaluated by measurements of bisect offset, lateral patellar displacement and patellar tilt angle. The nonparametric Wilcoxon test was utilized for statistical analysis of data resulting from the static and kinematic studies in both groups. Nonparametric Mann-Whitney test was utilized in the comparison between healthy volunteers and patients. RESULTS: Statistical analysis demonstrated significant differences (p < 0.05) between static and kinematic magnetic resonance imaging for the three parameters evaluated in both groups. Among the patients the differences between static and kinematic measurements were greater than those found in the volunteers, at 30° and 20° flexion, with bisect offset and lateral patellar displacement. CONCLUSION: Static and kinematic magnetic resonance imaging, when performed in association, demonstrated that the lateral forces being exerted on the patella are higher at a knee flexion at the range between 20° and 30°, particularly in individuals symptomatic for femoropatellar instability.

Condromatose sinovial de joelho: relato de caso

The authors report the case of a patient with synovial osteochondromatosis of the knee, who had previously been a soccer player.

Avaliação funcional da reconstrução do ligamento patelofemoral medial em atletas

Objective  The aim of the present study was to evaluate the clinical results, functional outcomes, and risk factors after anatomic reconstructions using knee flexor grafts in athletes. Methods  The authors followed-up 32 patients and 34 knees for 1 year in a prospective design case series evaluating pre- and postoperative functional scores (Kujala and Lysholm) and associated risk factors. Results  All of the 32 patients had a significant increase of the Lysholm and Kujala scores. Patients with < 5 preoperative dislocations had a better score on the Lysholm and Kujala scales. The mean preoperative Lysholm score was 62.8, and the mean postoperative score was 94.3. The mean preoperative Kujala score was 63.0, and the mean postoperative score was 94.0. Conclusion  Medial patellofemoral ligament reconstruction with hamstring graft in athletes with patellar instability improved clinical and functional scores. The bone drilling through the patella and the positioning of the femoral tunnel should be judiciously performed.

Bilateral osteochondritis dissecans of the knee in a basketball player: case report

The authors report a case of bilateral osteochondritis dissecans in a 17-year-old basketball player who was diagnosed and treated as shown in the literature.

Osteocondrite dissecante bilateral de joelho em jogador de basquetebol: relato de caso

The authors report a case of bilateral osteochondritis dissecans in a 17-year-old basketball player who was diagnosed and treated as shown in the literature.

Lipossarcoma de joelho em um atleta de tênis: relato de caso

Lipossarcoma is an uncommon malignant tumor. It originates in the mesenchymal cells, and is the most common of the soft tissue sarcomas. The authors report a case of a 40 year-old male tennis player with lipossarcoma in the posterior right knee and distal thigh region.

LIPOSARCOMA OF THE KNEE IN A TENNIS PLAyER: CASE REPORT

Liposarcoma is an uncommon malignant tumor. It originates in the mesenchymal cells, and is the most common of the soft tissue sarcomas. The authors report a case of a 40 year-old male tennis player with liposarcoma in the posterior right knee and distal thigh region.

Synovial chondromatosis of the knee: case report

The authors report the case of a patient with synovial osteochondromatosis of the knee, who had previously been a soccer player.