A Thermographic Evaluation of Patellar​ Tendon Partial Tear

about the thermographic evaluation of patellar tendon degeneration

“Many pathological processes in humans manifest themselves as local changes in heat production and also as changes in blood flow pattern at affected organs or tissues”. Vainer BG. FPA-based infrared thermography as applied to the study of cutaneous perspiration and stimulated a vascular response in humans. Phys Med Biol. 2005 Dec 7;50(23): R63–94. 

Since I met the human thermography I always use this kind of evaluation for diagnosis and monitoring of musculoskeletal diseases, together with all the other imaging modalities.

Today I show you the case of a young athlete practicing long jump, with a chronic patellar tendon tendinopathy and partial tear at its proximal attachment.

I always start with clinical examination and thermographic study.

termography-knee

Thermographic study of the painful right knee

termography knee normal

The thermographic evaluation of the healthy left knee shows a difference of 1,5°C less than the right one

Mri Patellar tendon Tendinopathy

Sagittal T1w – Fusion – Stir Mri of the same patient (0.3 Tesla)

I perform the MRI examination to have also the clear depiction of the cortical patellar bone; as you probably know in many similar cases a bone marrow edema is associated at the inferior pole of the patella.

The study is completed with the dynamic ultrasound exam, both in supine and orthostatic position.

The elastosonography evaluation shows less adaptive changes during the dynamic study, as is usually seen in these pathologic conditions.

I believe in integrated imaging study for musculoskeletal pathologies; thermal cameras are user-friendly for anyone is involved in the diagnosis, monitoring, and treatment of these kinds of pathological conditions.

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Lateral Meniscus Cyst

about ultrasound appearance of lateral meniscus cyst degeneration

In my previous post Meniscal Cyst I showed the ultrasound appearance of a medial meniscus cyst, together with a suspected meniscal tear. Today I present the case of a young football player that came to my observation one year after a lateral collateral partial strain injury. As you certainly know peripheral attachments of the lateral meniscus are more lax than on the medial side, permitting greater mobility of the lateral meniscus.

lateral-meniscus-cyst

The dynamic ultrasound exam allows to appreciate a gross meniscal fissuring, with a meniscal cyst and partial extrusion; no alterations were seen along the course of the lateral collateral ligament.

Meniscus extrusion is usually associated with meniscal degeneration and tears, so it is crucial to always perform also the Mri examination.

lateral-meniscus

Coronal T2w (left) and Axial T2w (right) Mri scans (0.3 Tesla). The meniscal cyst and degeneration are evident.

lateral-meniscus-complex-tear

Coronal T2w (left) and Axial T2w (right) Mri scans (0.3 Tesla). Complex tear of the lateral meniscus.