Diagnosis and Grading of the Chondromalacia of Patella using Axial Proton Density Spectral Attenuated Inversion Recovery (PD-SPAIR) and Axial Proton Density MRI Knee Sequences

Background: Chondromalacia of patella is a common disease characterized by softening and degeneration of the patellar articular cartilage and is a frequent cause of anterior knee pain in young adults. Objectives: The purpose of this study is to assess sensitivity, specificity and the accuracy of axial proton density –spectral attenuated inversion recovery MRI sequence in detecting and grading patellar cartilage in patients with chondromalacia patellae in comparison to axial proton density sequence. Patients and methods: Thirty patients with chondromalacia patellae would be included in our study, 18 patients were women and 12 were men, their ages ranged from 12-30 years old. Another thirty-one patients that underwent knee MRI for another knee problem will be included also as a standard control group, 23were males and 8 were females, their ages ranging from 13-36 years old. All these patients will be examined by MR imaging with 1.5 tesla imaging system using both the axial proton density- spectral attenuated inversion recovery (PD-SPAIR) and axial proton density (PD) sequences. The study was done in AL Emamain Alkadhmain medical city. All the results will be reviewed 2 radiologists; final grading of patellar chondromalacia was made with mutual agreement. Results: Sensitivity of PD-SPAIR and PD sequences was 86.7% and 70% respectively. Specificity was for PD-SPAIR 93.5% and 77.4% for PD sequences. Accuracy for detecting these lesions in comparison to the control groupwas90.1% for PD-SPAIR and 73.8% for PD sequence Conclusion: The axial proton density spectrum attenuated inversion recovery sequence may accurately and quickly detect and grade cartilage defects in chondromalacia patellae patients. Fat saturation and proton density–weighted sequences are sensitive to cartilage lesions and intramedullary osseous oedematous changes, thus they should substitute the traditional proton density sequence in these patients.