Dynamic ultrasonic research mediopatellary synovial folding knee joint

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Abstract

BACKGROUND: One of the reasons for the formation of pain syndrome in the anterior part of the knee joint is a pathologically thickened mediopatellar synovial plica (MP). MP most often pathologically changes and as a result leads to changes in the nearby structures of the knee joint. However, there are difficulties in assessing the direct impact of MPSS on the articular cartilage of the patella and medial condyle of the femur, for this it is advisable to perform ultrasound examination using functional tests.

AIM: To study the effectiveness of ultrasound examination with the use of functional tests in the diagnosis of MP pathology, which are important in determining tactics and evaluating treatment results.

MATERIALS AND METHODS: The results of a comparative survey of 80 patients are presented. The first stage of the MRI was performed on patients, according to which the type of change in MP was evaluated. The second stage was ultrasound with the use of functional tests.

RESULTS: According to MRI data, type A was detected in 11, type B in 17, type C in 38 and type D in 14 patients. Ultrasound results showed that type A and B MP were not infringed in any case, and type C and D MP were infringed in 24 (63.2%) and 12 (85.7%) cases, respectively.

CONCLUSION: The study made it possible to determine not only the presence or absence of pathologically thickened MP, but also to assess the degree of its influence on nearby joint structures, such as thickness, the degree of vascularization of both the fold itself and the synovial membrane around it, the presence or absence of infringement during flexion and extension of the knee joint and SHELF syndrome, and therefore, the degree of its participation in the formation of pain syndrome.

About the authors

Nikolay A. Eskin

N.N. Priorov National Medical Research Center of Traumatology and Orthopedics

Email: cito-uchsovet@mail.ru
ORCID iD: 0000-0003-4738-7348
SPIN-code: 1215-9279

MD, PhD, Dr. Sci. (Med.), professor, head of the department of ultrasound diagnostics

Russian Federation, Moscow

Alexander A. Ochkurenko

N.N. Priorov National Medical Research Center of Traumatology and Orthopedics

Email: cito-omo@mail.ru
ORCID iD: 0000-0002-1078-9725
SPIN-code: 8324-2383

MD, PhD, Dr. Sci. (Med.), professor, traumatologist-orthopedist

Russian Federation, Moscow

Fatima U. Kusova

N.N. Priorov National Medical Research Center of Traumatology and Orthopedics

Email: kusova_cito@mail.ru

MD, PhD, Cand. Sci. (Med.), ultrasound diagnostics doctor

Russian Federation, Moscow

Anton P. Kurpyakov

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Email: Avodatskiy@mail.ru
SPIN-code: 3398-7972

MD, PhD, Cand. Sci. (Med.), traumatologist-orthopedist

Russian Federation, Moscow

Alexandr Gorokhvodatsky

N.N. Priorov National Medical Research Center of Traumatology and Orthopedics

Author for correspondence.
Email: Avodatskiy@mail.ru
ORCID iD: 0000-0002-5855-1214
SPIN-code: 8033-8688

MD, traumatologist-orthopedist

Russian Federation, Moscow

Natalya Yu. Matveeva

N.N. Priorov National Medical Research Center of Traumatology and Orthopedics

Email: nymatveeva@gmail.com

MD, PhD, Cand. Sci. (Med.), ultrasound diagnostics doctor

Russian Federation, Moscow

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Supplementary files

Supplementary Files
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1. JATS XML
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2. Fig. 1. A picture of the mediopatellar synovial fold obtained using magnetic resonance imaging

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3. Fig. 2. Location of the limb and transducer during sonography of the mediopatellar synovial fold, as well as the dynamic test

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4. Fig. 3. Illustration and layout of the mediopatellar synovial fold of the knee joint

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5. Fig. 4. X-ray of the knee joint. Positions of the ultrasonic transducer during the study: 1 — the transducer is located incorrectly, more proximally; 2 — the sensor is in the correct position; 3 — the sensor is located incorrectly, more distally

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6. Fig. 5. Knee joint sonograms: a — sonogram when the sensor is located in the X-ray position 1, more proximally; b — sonogram when the sensor is located in the X-ray position 2, correct; c — sonogram when the sensor is located in X-ray position 3, more distally. Arrows indicate the mediopatellar synovial fold

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7. Fig. 6. Sonograms before (a) and after (b) the dynamic test. Arrows indicate the mediopatellar synovial fold

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8. Fig. 7. Position of the transducer and limb in the study of the mediopatellar synovial fold (a) and the dynamic test (b)

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