What’s new about Kienböck’s disease

Abstract

Chondromalacia patella consists in a progressive degradation and ulceration of hyaline cartilage of the patella, involving, during time, underlying bone with reactive changes. In this review is pointed out the role of radiological imaging in providing accurate morphological (type and grade of the lesions) and mechanical (tracking abnormalities due to malalignament and instability) information about patellofemoral joint. This information is critical for therapeutic decision making. Conventional radiology, usually, gives a careful characterization of osteoarthritic changes of articular bone, however these are late findings. CT improves the visualization of the articular bone and allows a better identification of early degenerative changes. Moreover CT gives a definite measure of malalignament of the patella, allowing a precise surgical correction, if needed. Currently CT is though to be the best modality to achieve a full bony assessment. Changes in the articular cartilage, however, must be inferred, because CT doesn’t permit a direct visualization of cartilage. Eventually MR provides a unique non invasive means of imaging the articular cartilage, it allows an accurate grading system to evaluate the severity of hyaline cartilage injuries. This grading system correlates well with arthroscopy. MR is the modality of choice when on the basis of clinical screening, an articular damage is suspected in an early phase.