Patella-patellar tendon angle and lateral patella-tilt angle decrease patients with chondromalacia patella.

PURPOSE: The aim of the present study was to evaluate the effect of patellofemoral joint morphology and patellar alignment (lateral patellar tilt and sagittal patellar tilt) on the presence and stage of CP, and identify the differences between sexes. METHODS: MRI of 243 patients [146 men (60.1%)] were evaluated retrospectively. Patients were grouped as normal group without chondromalacia, group with mild chondromalacia (grades 1-2) and group with severe chondromalacia (grades 3-4). Sagittal patellofemoral alignment was assessed by the angle between the patella and patellar tendon (P-PTA), and the angle between the quadriceps tendon and patella (Q-PA). Patellar tilt was assessed by lateral patellar tilt angle (LPTA). In addition, patellofemoral joint morphology was evaluated by measuring trochlear depth (TD), trochlear sulcus angle (TSA) and patella angle (PA). RESULTS: P-PTA, Q-PA, LPTA and TD values were significantly lower in patients with severe chondromalacia than in patients with both normal and mild chondromalacia (P < 0.001). TSA values were significantly higher in patients with severe chondromalacia than those with both normal and mild chondromalacia (P < 0.001). TSA was higher and TD was lower in women compared to men (P < 0.001). LPTA and P-PTA were lower in women compared to men, and the difference was significant. There was no difference in PA between the two sexes. CONCLUSIONS: Patellar cartilage degeneration increases with trochlear dysplasia. There is a strong correlation between patellar malalignment (lateral patellar tilt and sagittal patellar tilt) and chondromalacia patella. Women are more prone to developing CP than men.

Correction to: Patella-patellar tendon angle and lateral patella-tilt angle decrease patients with chondromalacia patella.

The original article can be found online.

The Relationship Between Nasal Septal Deviation and Paranasal Pneumatization.

OBJECTIVE: To investigate the impact of the presence and the severity of the nasal septal deviation (NSD) on the paranasal pneumatization. METHODS: Initially, the deviated and contralateral sides was compared to evaluate the impact of the presence of NSD on pneumatization. Then, NSD classification groups were categorized according to the severity of deviation degree; 1: mild (<9°), 2: moderate (9°-15°), and 3: severe (>15°). Pneumatization of all paranasal sinuses, osteomeatal complex (OMC), frontoethmoid recess (FER) and variant structures were compared according to the NSD classification groups separately both for the deviated and the contralateral sides. RESULTS: Although there was no statistically significant difference in pneumatization of the paranasal sinuses between the deviated and contralateral sides, a significant difference was observed in OMC and FER diameters. In the deviated side, there was statistically significant difference in ethmoid sinus volume, in FER and OMC diameters between NSD classification groups. In the contralateral side, FER and OMC diameters were found to be significantly different between group 1 and group 2 and between group 1 and group 3, respectively (P = 0.04 and 0.06, respectively). Both the presence and severity of the NSD did not statistically significant influence the pneumatization of variant structures, air cells and vital structures. CONCLUSION: The severity of NSD effects the ethmoid sinus volume. The relationship of FER and OMC with NSD is evident, however this may not always be in a proportional pattern. The paranasal pneumatization did not affect Keros type, bone integrity of carotid canal and optic canal.

Papillary Tumor of the Pineal Region with Parinaud Syndrome: A Case Report.

Backround: Less than 1% of all intracranial tumors are in the pineal region. Papillary tumor of the pineal region is considered one of four pineal parenchymal tumors according to the 2007 World Health Organisation classification of central nervous system tumors. It is mostly seen in the middle age and it is rare under the age of 17 in the literature. In this report, we aim to present a case with papillary tumor of the pineal region with both CT and MRI findings, and discuss the differential diagnosis. Case report: A 17-year-old female patient who underwent a treatment of ventriculoperitoneal shunt due to hydrocephalus 18 months ago applied to the neurosurgery clinic with nausea, vomiting, sensorineural hearing loss and Parinaud syndrome continuing through 1 month. Computed tomography (CT) and magnetic resonance imaging (MRI) have been applied. A 58x31x38 mm mass with cystic and mild hyperdense soft tissue components was observed in the localization of pineal gland and posterior comissure on non-enhanced CT. MRI examination revealed that the mass filled the pineal region, contained solid and large cystic components, and hyperintense on T1-weighted images. After intravenous contrast media injection, the mass enhanced more peripherally. DW-MRI showed that there is a diffusion restriction in some parts of the soft tissue components. The mass was totally resected, and pathology report revealed that it is a papillary tumor of the pineal region. Conclusion: When a T1-weighted hyperintense and CT hyperdense mass with cystic and solid components is seen in the pineal region, even if it is rare, papillary tumor should also be considered in the differential diagnosis after exclusion of other hyperintense lesions in T1-weighted imaging.

Magnetic resonance arthrographic evaluation of syndesmotic diastasis in ankle fractures.

INTRODUCTION: We examined whether magnetic resonance arthrography (MRA) contributes to the diagnosis of syndesmotic complex disruption in ankle fractures. Patients suffering syndesmotic diastasis according to conventional radiographic criteria were evaluated by MRI and MRA. MATERIAL AND METHODS: Fifteen patients (15 ankles) with Denis-Weber type B and C fractures and were suspected of having syndesmotic diastasis considering tibiofibular clear space and tibiofibular overlap measurements in conventional radiographs were prospectively evaluated by MRI and MRA methods. Syndesmotic diastasis was diagnosed by radiographic, MRI, and MRA findings and by intraoperative observation and assessment criteria. Differences between MRI and MRA findings were tested statistically. Conventional radiography, MRI, and MRA results were analyzed by two independent observers, and interobserver concordance was also assessed. RESULTS: In 15 patients regarded to have syndesmotic diastasis on conventional radiography the diagnosis was confirmed in 8 (53.3%) with MRI and 12 (80%) with MRA. Following overall assessment 13 of 15 patients (86.6%) were determined to have diastasis. There were statistically significant differences in diagnosis after MRI and after MRA. There was interobserver concordance in conventional radiographic, MRA assessments, and in assessments for anterior and posterior tibiofibular ligaments separately in MRI. CONCLUSIONS: These results suggest that conventional radiography and MRI is not sufficient in assessing syndesmotic disruption, and that MRA can make an important contribution to diagnosis in ankle fractures.