Dynamic ultrasonic research mediopatellary synovial folding knee joint

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.

Keywords

knee joint / mediopatellar synovial fold / MRI / ultrasound / functional tests

References

[1] Ogata S, Uhthoff HK. The development of synovial plicae in human knee joints: an embryologic study. Arthroscopy. 1990;6(4):315–321. doi: 10.1016/0749-8063(90)90063-j

[2] Ogata S., Uhthoff H.K. The development of synovial plicae in human knee joints: an embryologic study // Arthroscopy. 1990. Vol. 6, N 4. P. 315–321. doi: 10.1016/0749-8063(90)90063-j

[3] Pipkin G. Knee injuries: the role of the suprapatellar plica and suprapatellar bursa in simulating internal derangements. Clin Orthop Relat Res. 1971;74:161–176.

[4] Pipkin G. Knee injuries: the role of the suprapatellar plica and suprapatellar bursa in simulating internal derangements // Clin Orthop Relat Res. 1971. Vol. 74. P. 161–176.

[5] Anderson H. Histochemical studies on the histogenesis of the knee and superior tibio fibular joints. Acta Anat (Basel). 1961;46:279–303. doi: 10.1159/000141791

[6] Anderson H. Histochemical studies on the histogenesis of the knee and superior tibio fibular joints // Acta Anat (Basel). 1961. Vol. 46. P. 279–303. doi: 10.1159/000141791

[7] Calpur OU, Copuroglu C, Ozcan M. United unresorbed medial and lateral plicae as anterior mesenchymal synovial septal remnant. Knee Surg Sports Traumatol Arthrosc. 2002;10(6):378–380. doi: 10.1007/s00167-002-0297-8

[8] Calpur O.U., Copuroglu C., Ozcan M. United unresorbed medial and lateral plicae as anterior mesenchymal synovial septal remnant // Knee Surg Sports Traumatol Arthrosc. 2002. Vol. 10, N 6. P. 378–380. doi: 10.1007/s00167-002-0297-8

[9] Broukhim B, Fox JM, Blazina ME, et al. The synovial shelf syndrome. Clin Orthop Relat Res. 1979;(142):135–138.

[10] Broukhim B., Fox J.M., Blazina M.E., et al. The synovial shelf syndrome // Clin Orthop Relat Res. 1979. N 142. P. 135–138.

[11] Jackson RW, Marshall DJ, Fujisawa Y. The pathological medial shelf. Orthop Clin North Am. 1982;13(2):307–312.

[12] Jackson R.W., Marshall D.J., Fujisawa Y. The pathological medial shelf // Orthop Clin North Am. 1982. Vol. 13, N 2. P. 307–312.

[13] Mital MA, Hayden J. Pain in the knee in children: the medial plica shelf syndrome. Orthop Clin North Am. 1979;10(3):713–722.

[14] Mital M.A., Hayden J. Pain in the knee in children: the medial plica shelf syndrome // Orthop Clin North Am. 1979. Vol. 10, N 3. P. 713–722.

[15] Moller H. Incarcerating mediopatellar synovial plica syndrome. Acta Orthop Scand. 1981;52(3):357–361. doi: 10.3109/17453678109050115

[16] Moller H. Incarcerating mediopatellar synovial plica syndrome // Acta Orthop Scand. 1981. Vol. 52, N 3. P. 357–361. doi: 10.3109/17453678109050115

[17] Schindler OS. ‘The Sneaky Plica’ revisited: morphology, pathophysiology and treatment of synovial plicae of the knee. Knee Surg Sports Traumatol Arthrosc. 2014;22(2):247–262. doi: 10.1007/s00167-013-2368-4

[18] Schindler O.S. ‘The Sneaky Plica’ revisited: morphology, pathophysiology and treatment of synovial plicae of the knee // Knee Surg Sports Traumatol Arthrosc. 2014. Vol. 22, N 2. P. 247–262. doi: 10.1007/s00167-013-2368-4

[19] Yuan HF, Guo CA, Yan ZQ. Mediopatellar plica as a risk factor for knee osteoarthritis. Chin Med J (Engl). 2015;128(2):277–278. doi: 10.4103/0366-6999.149237

[20] Yuan H.F., Guo C.A., Yan Z.Q. Mediopatellar plica as a risk factor for knee osteoarthritis // Chin Med J (Engl). 2015. Vol. 128, N 2. P. 277–278. doi: 10.4103/0366-6999.149237

[21] Wang HS, Kuo PY, Yang CC, Lyu SR. Matrix metalloprotease-3 expression in the medial plica and pannus-like tissue in knees from patients with medial compartment osteoarthritis. Histopathology. 2011;58(4):593–600. doi: 10.1111/j.1365-2559.2011.03783.x

[22] Wang H.S., Kuo P.Y., Yang C.C., Lyu S.R. Matrix metalloprotease-3 expression in the medial plica and pannus-like tissue in knees from patients with medial compartment osteoarthritis // Histopathology. 2011. Vol. 58, N 4. P. 593–600. doi: 10.1111/j.1365-2559.2011.03783.x

[23] Dupont JY. Synovial plicae of the knee. Controversies and review. Clin Sports Med. 1997;16(1):87–122. doi: 10.1016/s0278-5919(05)70009-0

[24] Dupont J.Y. Synovial plicae of the knee. Controversies and review // Clin Sports Med. 1997. Vol. 16, N 1. P. 87–122. doi: 10.1016/s0278-5919(05)70009-0

[25] ultrasound.net.ua [Internet]. Abstracts of the V Congress of UAFUD 2016 [cited 2021 Sep 30]. Ponomarenko SA, Abdullaev RYa, Sysun LA, Kalashnikov VI. Ul’trazvukovaya diagnostika patologii sinovial’nykh skladok kolennykh sustavov; [about 1 screen]. Available from: http://ultrasound.net.ua/materiali/materialii-konferencii-ta-zjizdiv/v-kongres-uafud-2016/tezi-v-kongresu-uafud/ultrazvukovaja-diagnostika-patologii-sinovialnykh-skladok-kolennykh-sustavov/

[26] ultrasound.net.ua [интернет]. Тезисы V Конгресса УАФУД 2016. Дата обращения: 30.09.2021]. Пономаренко С.А., Абдуллаев Р.Я., Сысун Л.А., Калашников В.И. Ультразвуковая диагностика патологии синовиальных складок коленных суставов; [около 1 страницы]. Доступ по ссылке: http://ultrasound.net.ua/materiali/materialii-konferencii-ta-zjizdiv/v-kongres-uafud-2016/tezi-v-kongresu-uafud/ultrazvukovaja-diagnostika-patologii-sinovialnykh-skladok-kolennykh-sustavov/

[27] Lee YH, Song HT, Kim S, et al. Infrapatellar plica of the knee: revisited with MR arthrographies undertaken in the knee flexion position mimicking operative arthroscopic posture. Eur J Radiol. 2012;81(10):2783–2787. doi: 10.1016/j.ejrad.2011.12.028

[28] Lee Y.H., Song H.T., Kim S., et al. Infrapatellar plica of the knee: revisited with MR arthrographies undertaken in the knee flexion position mimicking operative arthroscopic posture // Eur J Radiol. 2012. Vol. 81, N 10. P. 2783–2787. doi: 10.1016/j.ejrad.2011.12.028

[29] Weckstrom M, Niva MH, Lamminen A, et al. Arthroscopic resection of medial plica of the knee in young adults. Knee. 2010;17(2):103–107. doi: 10.1016/j.knee.2009.07.010

[30] Weckstrom M., Niva M.H., Lamminen A., et al. Arthroscopic resection of medial plica of the knee in young adults // Knee. 2010. Vol. 17, N 2. P. 103–107. doi: 10.1016/j.knee.2009.07.010

[31] Sakakibara J. Arthroscopic study on lino’s band (plica synovialis mediopatellaris). J Jpn Orthop Assoc. 1976;50:513–522.

[32] Sakakibara J. Arthroscopic study on Iino’s band (plica synovialis mediopatellaris) // J Jpn Orthop Assoc. 1976. Vol. 50. P. 513–522.

[33] Paczesny L, Kruczynski J. Medial plica syndrome of the knee: diagnosis with dynamic sonograph radiology. Radiology. 2009;251(2):439–446. doi: 10.1148/radiol.2512081652

[34] Paczesny L., Kruczynski J. Medial plica syndrome of the knee: diagnosis with dynamic sonograph radiology // Radiology. 2009. Vol. 251, N 2. P. 439–446. doi: 10.1148/radiol.2512081652

[35] Grobbelaar N, Bouffard JA. Sonography of the knee, a pictorial review. Semin Ultrasound CT MR. 2000;21(3):231–274. doi: 10.1016/s0887-2171(00)90045-3

[36] Grobbelaar N., Bouffard J.A. Sonography of the knee, a pictorial review // Semin Ultra- sound CT MR. 2000. Vol. 21, N 3. P. 231–274. doi: 10.1016/s0887-2171(00)90045-3

[37] Karim Z, Wakefield RJ, Quinn M, et al. Validation and reproducibility of ultrasonography in the detection of synovitis in the knee: a comparison with arthroscopy and clinical examination. Arthritis Rheum. 2004;50(2):387–394. doi: 10.1002/art.20054

[38] Karim Z., Wakefield R.J., Quinn M., et al. Validation and reproducibility of ultrasonography in the detection of synovitis in the knee: a comparison with arthroscopy and clinical examination // Arthritis Rheum. 2004. Vol. 50, N 2. P. 387–394. doi: 10.1002/art.20054

[39] Munzinger U, Ruckstuhl J, Scherrer H, Gschwend N. Internal derangement of the knee joint due to pathologic synovial folds: the mediopatellar plica syndrome. Clin Orthop Relat Res. 1981;(155):59–64.

[40] Munzinger U., Ruckstuhl J., Scherrer H., Gschwend N. Internal derangement of the knee joint due to pathologic synovial folds: the mediopatellar plica syndrome // Clin Orthop Relat Res. 1981. N 155. P. 59–64.

[41] Guney A, Bilal O, Oner M, et al. Short- and mid-term results of plica excision in patients with mediopatellar plica and associated cartilage degeneration. Knee Surg Sports Traumatol Arthrosc. 2010;18(11):1526–1531. doi: 10.1007/s00167-010-1125-1

[42] Guney A., Bilal O., Oner M., et al. Short- and mid-term results of plica excision in patients with mediopatellar plica and associated cartilage degeneration // Knee Surg Sports Traumatol Arthrosc. 2010. Vol. 18, N 11. P. 1526–1531. doi: 10.1007/s00167-010-1125-1

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