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Patients with patellofemoral pain exhibit elevated bone metabolic activity at the patellofemoral joint
Author(s) -
Draper Christine E.,
Fredericson Michael,
Gold Garry E.,
Besier Thor F.,
Delp Scott L.,
Beaupre Gary S.,
Quon Andrew
Publication year - 2012
Publication title -
journal of orthopaedic research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.041
H-Index - 155
eISSN - 1554-527X
pISSN - 0736-0266
DOI - 10.1002/jor.21523
Subject(s) - patellofemoral joint , medicine , patella , metabolic activity , knee pain , bone remodeling , knee joint , nuclear medicine , orthodontics , osteoarthritis , surgery , pathology , physiology , alternative medicine
Abstract Patellofemoral pain is characterized by pain behind the kneecap and is often thought to be due to high stress at the patellofemoral joint. While we cannot measure bone stress in vivo, we can visualize bone metabolic activity using 18 F NaF PET/CT, which may be related to bone stress. Our goals were to use 18 F NaF PET/CT to evaluate whether subjects with patellofemoral pain exhibit elevated bone metabolic activity and to determine whether bone metabolic activity correlates with pain intensity. We examined 20 subjects diagnosed with patellofemoral pain. All subjects received an 18 F NaF PET/CT scan of their knees. Uptake of 18 F NaF in the patella and trochlea was quantified by computing the standardized uptake value and normalizing by the background tracer uptake in bone. We detected increased tracer uptake in 85% of the painful knees examined. We found that the painful knees exhibited increased tracer uptake compared to the pain‐free knees of four subjects with unilateral pain ( P = 0.0006). We also found a correlation between increasing tracer uptake and increasing pain intensity ( r 2 = 0.55; P = 0.0005). The implication of these results is that patellofemoral pain may be related to bone metabolic activity at the patellofemoral joint. © 2011 Orthopaedic Research Society Published by Wiley Periodicals, Inc. J Orthop Res 30:209–213, 2012