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Factors associated with magnetic resonance imaging defined patellar tendinopathy in community-based middle-aged women: a prospective cohort study.

Toppi J, Fairley J, Cicuttini FM, Cook J, Davis SR, Bell RJ, Hanna F, Wang Y - BMC Musculoskelet Disord (2015)

Bottom Line: However there is little data in community-based populations.Height and weight were measured to calculate body mass index (BMI).In community-based middle-aged women MRI-diagnosed patellar tendinopathy is common, with higher levels of physical activity and greater vastus medialis size being risk factors suggesting a biomechanical effect.

View Article: PubMed Central - PubMed

Affiliation: Department of Epidemiology and Preventive Medicine, Monash University, Alfred Hospital, Melbourne, VIC, 3004, Australia. jttoppi@gmail.com.

ABSTRACT

Background: Patellar tendinopathy identified by imaging modalities has been reported in asymptomatic athletes and associated with tendon-related symptoms. However there is little data in community-based populations. The aim of this cohort study was to examine the prevalence of magnetic resonance imaging (MRI) defined patellar tendinopathy, the factors associated with this condition, and whether it was associated with knee pain in community-based middle-aged women.

Methods: One hundred seventy six women, aged 40-67 years, with no significant knee pain or injury underwent knee MRI. Patellar tendinopathy was defined on both T1- and T2-weighted fat-saturated MRIs. The cross-sectional area of vastus medialis was measured from MRI. Height and weight were measured to calculate body mass index (BMI). Physical activity was assessed using a questionnaire. Knee pain was assessed using the Western Ontario and McMaster University Osteoarthritis Index.

Results: The prevalence of MRI defined patellar tendinopathy was 30.1%. Higher levels of physical activity (odds ratio 1.65, 95% CI 1.09-2.51) and greater vastus medialis cross-sectional area (odds ratio 1.22, 95% CI 1.04-1.43) were associated with increased prevalence of patellar tendinopathy, independent of age and BMI. The persistence of patellar tendinopathy was associated with the worsening of knee pain over 2 years (odds ratio 10.65, 95% CI 1.14-99.77).

Conclusion: In community-based middle-aged women MRI-diagnosed patellar tendinopathy is common, with higher levels of physical activity and greater vastus medialis size being risk factors suggesting a biomechanical effect. Persistent patellar tendinopathy is associated with worsening of knee pain. These findings suggest that further work is needed to determine the contribution of patellar tendinopathy on knee pain and function in older people.

No MeSH data available.


Related in: MedlinePlus

Patellar tendinopathy on MRI. a Sagittal T1-weighted fat-saturated image showing patellar tendinopathy. b Coronal T2-weighted fat-saturated image showing patellar tendinopathy
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Fig1: Patellar tendinopathy on MRI. a Sagittal T1-weighted fat-saturated image showing patellar tendinopathy. b Coronal T2-weighted fat-saturated image showing patellar tendinopathy

Mentions: Patellar tendinopathy was defined as an area of increased signal intensity of characteristic pattern, size and distribution on at least two adjacent slices in the proximal region of the inferior patellar tendon. Two trained observers, who were blinded to participant characteristics, assessed the presence of patellar tendinopathy for each participant on T1-weighted fat-saturated sagittal images. T2-weighted fat-saturated coronal images were used to confirm the presence of patellar tendinopathy and ensure a magic angle effect was not contributing to positive results. When echo time is short, increased signal intensity can be observed in the presence of no pathology. This artificially increased intensity can potentially be confused with disease and is known as the magic angle effect. To overcome the magic angle effect, a T2-weighted sequence can be applied [24], which was done in this study. The patellar tendon was graded as either ‘definite tendinopathy’ or ‘no tendinopathy’ [11, 24, 25] (Fig. 1). The intra-observer and inter-observer reproducibility for determination of definite patellar tendinopathy, assessed using 50 randomly selected knee MRI scans, was 0.94 and 0.90 (expressed as intra-class correlation coefficient, ICC), respectively. The persistence of patellar tendinopathy was defined as those who had ‘definite tendinopathy’ at both baseline and 2 years later.Fig. 1


Factors associated with magnetic resonance imaging defined patellar tendinopathy in community-based middle-aged women: a prospective cohort study.

Toppi J, Fairley J, Cicuttini FM, Cook J, Davis SR, Bell RJ, Hanna F, Wang Y - BMC Musculoskelet Disord (2015)

Patellar tendinopathy on MRI. a Sagittal T1-weighted fat-saturated image showing patellar tendinopathy. b Coronal T2-weighted fat-saturated image showing patellar tendinopathy
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4526288&req=5

Fig1: Patellar tendinopathy on MRI. a Sagittal T1-weighted fat-saturated image showing patellar tendinopathy. b Coronal T2-weighted fat-saturated image showing patellar tendinopathy
Mentions: Patellar tendinopathy was defined as an area of increased signal intensity of characteristic pattern, size and distribution on at least two adjacent slices in the proximal region of the inferior patellar tendon. Two trained observers, who were blinded to participant characteristics, assessed the presence of patellar tendinopathy for each participant on T1-weighted fat-saturated sagittal images. T2-weighted fat-saturated coronal images were used to confirm the presence of patellar tendinopathy and ensure a magic angle effect was not contributing to positive results. When echo time is short, increased signal intensity can be observed in the presence of no pathology. This artificially increased intensity can potentially be confused with disease and is known as the magic angle effect. To overcome the magic angle effect, a T2-weighted sequence can be applied [24], which was done in this study. The patellar tendon was graded as either ‘definite tendinopathy’ or ‘no tendinopathy’ [11, 24, 25] (Fig. 1). The intra-observer and inter-observer reproducibility for determination of definite patellar tendinopathy, assessed using 50 randomly selected knee MRI scans, was 0.94 and 0.90 (expressed as intra-class correlation coefficient, ICC), respectively. The persistence of patellar tendinopathy was defined as those who had ‘definite tendinopathy’ at both baseline and 2 years later.Fig. 1

Bottom Line: However there is little data in community-based populations.Height and weight were measured to calculate body mass index (BMI).In community-based middle-aged women MRI-diagnosed patellar tendinopathy is common, with higher levels of physical activity and greater vastus medialis size being risk factors suggesting a biomechanical effect.

View Article: PubMed Central - PubMed

Affiliation: Department of Epidemiology and Preventive Medicine, Monash University, Alfred Hospital, Melbourne, VIC, 3004, Australia. jttoppi@gmail.com.

ABSTRACT

Background: Patellar tendinopathy identified by imaging modalities has been reported in asymptomatic athletes and associated with tendon-related symptoms. However there is little data in community-based populations. The aim of this cohort study was to examine the prevalence of magnetic resonance imaging (MRI) defined patellar tendinopathy, the factors associated with this condition, and whether it was associated with knee pain in community-based middle-aged women.

Methods: One hundred seventy six women, aged 40-67 years, with no significant knee pain or injury underwent knee MRI. Patellar tendinopathy was defined on both T1- and T2-weighted fat-saturated MRIs. The cross-sectional area of vastus medialis was measured from MRI. Height and weight were measured to calculate body mass index (BMI). Physical activity was assessed using a questionnaire. Knee pain was assessed using the Western Ontario and McMaster University Osteoarthritis Index.

Results: The prevalence of MRI defined patellar tendinopathy was 30.1%. Higher levels of physical activity (odds ratio 1.65, 95% CI 1.09-2.51) and greater vastus medialis cross-sectional area (odds ratio 1.22, 95% CI 1.04-1.43) were associated with increased prevalence of patellar tendinopathy, independent of age and BMI. The persistence of patellar tendinopathy was associated with the worsening of knee pain over 2 years (odds ratio 10.65, 95% CI 1.14-99.77).

Conclusion: In community-based middle-aged women MRI-diagnosed patellar tendinopathy is common, with higher levels of physical activity and greater vastus medialis size being risk factors suggesting a biomechanical effect. Persistent patellar tendinopathy is associated with worsening of knee pain. These findings suggest that further work is needed to determine the contribution of patellar tendinopathy on knee pain and function in older people.

No MeSH data available.


Related in: MedlinePlus