Ultrasound-Guided Knee Cartilage Exploration: An Assessment Protocol
DOI:
https://doi.org/10.25759/spmfr.494Keywords:
Cartilage, Articular/diagnostic imaging, Knee Joint/diagnostic imaging, UltrasonographyAbstract
Introduction: The knee joint consists of three distinct articulations: medial and lateral femorotibial joints and the patellofemoral joint. It is composed of hyaline articular cartilage that envelops the femoral condyles, tibial plateaus, trochlear grooves, and patellar facets. Additionally, fibrocartilaginous menisci are present. Ultrasonography (US) is increasingly employed in musculoskeletal medicine for precise measurement and identification. This study aims to develop a systematic ultrasound evaluation of knee cartilage to enhance diagnostic accuracy and therapeutic guidance by recognizing the typical anatomical structure.Methods: The authors describe a stepwise protocol for ultrasound exploration of the cartilaginous components of the knee joint with a special focus on patient positioning, ultrasound probe placement, and commonly encountered ultrasound images in knee cartilage exploration. A linear probe (9-12 MHz) was used..
Results: On the anterior surface of the knee, it is possible to assess ultrasound imaging of the trochlear cartilage of the femur and the patellar cartilage, the latter partially. The patient should perform a maximum flexion of the knee to expose a greater amount of trochlear cartilage. To assess the medial meniscus, the patient should be in a supine position with the knee flexed at approximately 30o and the leg externally rotated. For evaluating the lateral meniscus, the patient should be in a supine position with the knee flexed at approximately 30o and the leg internally rotated. On the posterior surface of the knee, it is possible to assess ultrasound imaging of the posterior articular cartilage of the femoral condyles as well as the posterior horns of the menisci. The patient should perform a prone position with a complete extension of the knee.
Conclusion: In summary, the ultrasound protocol for evaluating knee cartilage is crucial due to its accessibility, cost-effectiveness, real-time imaging, and ability to measure cartilage thickness. While additional imaging may be necessary for a thorough diagnosis, due to the limitations of using US, the ultrasound protocol significantly enhances knee cartilage assessment and improves overall patient care.
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