The evaluation of quadriceps tendon thickness and patellar tendon thickness and area by ultrasonography in patients with patellofemoral pain syndrome

Patellofemoral ağrı sendromunun (PFAS), diz bölgesindeki hasarların neredeyse %25'inde rol oynadığı bilinmektedir. Yüksek prevalansına rağmen, PFAS tanısı için altın standart bir muayene ve görüntüleme yöntemi halen mevcut değildir. PFAS'ta hastalık patogenezinde rolü olduğu öne sürülmüş ve diz ekleminin önemli destekleyicilerinden olan kuadriseps ve patellar tendonların ultrasonografik olarak ölçülen kalınlıkları, ilk defa çalışmamızda yaş ve cinsiyet açısından eş sağlıklı bireylerle kıyaslanmıştır. Çalışmaya Ocak- Aralık 2016 tarihlerinde Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi FTR Kliniğine başvuran ve çalışmaya dahil edilme ve çıkarılma kriterlerini sağlayan toplam 61 gönüllü alınmıştır. 61 kişiden 30'u patellofemoral ağrı sendromu tanısı almış bireyler, geri kalan 31'i ise yaş ve cinsiyet açısından eş kontrol bireyleridir. Sağlıklı bireylerin yaş ortalaması 30.03± 5.67 yıldır ve %45.2'si erkek cinsiyettir. Hasta grubunun yaş ortalaması ise 31.57± 7.37 yıldır ve bireylerin %46.7'si erkek cinsiyettir. Gruplar arasında meslek, öğrenim durumu gibi sosyodemografik parametreler ile vücut kitle indeksi değerleri arasında anlamlı farklılık gözlenmemiştir (p>0.05). Ayakta, supin pozisyonda ve oturur pozisyonda ölçülen Q açısı hasta grubunda sağlıklı gönüllüler ile kıyaslandığında anlamlı biçimde daha yüksek saptanmıştır (sırasıyla p0.05). Yapılan ROC eğrisi analizi sonucunda, PFAS varlığını ortaya koymada, patellar tendon kalınlığının ≥0.35 cm olmasının %66.7 sensitivite ve %67.7 spesifisiteye sahip olduğu görülmüştür (eğri altında kalan alan: 0.771, %95 güven aralığı: 0.655- 0.887, p0.05). Q angle values were statistically significantly higher in the patient group when compared to controls at standing, supine and sitting positions (p0.05). Patellar tendon thickness values of ≥0.35 cm were found to have 66.7% sensitivity and 67.7% specificity for PFAS diagnosis in the ROC curve analysis (area under curve: 0.771, 95% confidence interval: 0.655- 0.887, p< 0.001). Quadriceps tendon thickness values of ≥ 0.54 cm were found to have 80% sensitivity and 71% specificity for PFAS diagnosis in the ROC curve analysis (area under curve: 0.824, 95% confidence interval: 0.710- 0.939, p<0.001). In PFAS patients, ultrasonographically measured quadriceps tendon thickness has been found to have statistically significant positive correlation with age (r=0.405, p= 0.027) and BMI (r=0.450, p=0.013);and statistically significant negative correlation with Kujala score (r= -0.441, p=0.015). In the multivariate regression analysis, quadriceps tendont hickness has predicted PFAS diagnosis independently (Exp (B): 3.089, 95% confidenceinterval: 1.344—7.100, p= 0.008). Our study demonstrates that ultrasonographically measured patellar and quadriceps tendon thicknesses are significantly higher in subjects diagnosedwith PFAS and particularly, quadriceps tendon thickness may be used for the diagnosis

Ultrasonographic assessment of quadriceps and patellar tendon thicknesses in patients with patellofemoral pain syndrome

WOS:000484851600007PubMed ID: 31103417Objective: The aim of this study was to compare ultrasonographically measured quadriceps and patellar tendon thicknesses between Patellofemoral Pain Syndrome (PFPS) patients and age- and gendermatched healthy controls. Methods: Among patients who presented to physical therapy and rehabilitation outpatient clinic in JanuaryeDecember 2016, 61 volunteers (28 men and 33 women; mean age: 30.79 6.55 years) who were eligible considering the inclusion and exclusion criteria were enrolled. 30 were diagnosed with PFPS, and the remaining were age- and gender-matched healthy volunteers. Mean age was 30.03 5.67 years in healthy subjects and 45.2% were of male gender. The patient group had mean age of 31.57 7.37 years and 46.7% of the patients were male. Q angles were measured at standing, supine and sitting positions. Patellar and femoral tendon thicknesses and areas were measured ultrasonographically. Kujala questionnaire were used to evaluate the functional status of the participants. Results: No signi?cant difference was detected between groups regarding profession, educational background, and body mass indices (BMI) (p 0.05). Q angle values were signi?cantly higher in the patient group when compared to controls at standing (17.03 3.84 vs.13.87 1.75,p 0.001), supine (16.20 3.74 vs.13.45 1.79,p¼0.001) and sitting (16.50 3.28 vs.13.71 1.72,p 0.001) positions. Kujala score was signi?cantly lower in the PFPS group when compared to controls (70.57 8.37 vs. 98.58 2.05, p 0.001). Patellar (0.39 0.08 vs. 0.32 0.05 cm, p 0.001) and quadriceps (0.64 0.10 vs. 0.52 0.09 cm, p 0.001) tendon thicknesses were signi?cantly higher in the PFPS group when compared to controls. There was no signi?cant difference between groups regarding patellar tendon areas (p 0.05). Patellar tendon thickness values of 0.35 cm were found to have 66.7% sensitivity and 67.7% speci?city for PFPS diagnosis in the ROC curve analysis (area under curve: 0.771, 95% con?dence interval: 0.655e0.887, p 0.001). Quadriceps tendon thickness values of 0.54 cm were found to have 80% sensitivity and 71% speci?city for PFPS diagnosis in the ROC curve analysis (area under curve: 0.824, 95% con?dence interval: 0.710e0.939, p 0.001). In PFPS patients, quadriceps tendon thickness had signi?cant positive correlation with age (r ¼ 0.405, p ¼ 0.027) and BMI (r ¼ 0.450, p ¼ 0.013); and signi?cant negative correlation with Kujala score (r ¼0.441, p ¼ 0.015). In the multivariate regression analysis, quadriceps tendon thickness was independently associated with the presence of PFPS (Exp (B): 3.089, 95% con?dence interval: 1.344e7.100, p ¼ 0.008). Conclusion: Our study demonstrates that ultrasonographically measured patellar and quadriceps tendon thicknesses are signi?cantly higher in subjects with PFPS and particularly, quadriceps tendon thickness may be used for the diagnosis