Radiological evaluation of patellofemoral instability and possible causes of assessment errors

Patellofemoral instability(PI)is the disruption of the patella’s relationship with the trochlear groove as a result of abnormal movement of the patella.To identify the presence of PI,conventional radiographs(anteroposterior,lateral,and axial or skyline views),magnetic resonance imaging,and computed tomography are used.In this study,we examined four main instability factors:Trochlear dysplasia,patella alta,tibial tuberosity–trochlear groove distance,and patellar tilt.We also briefly review some of the other assessment methods used in the quantitative and qualitative assessment of the patellofemoral joint,such as patellar size and shape,lateral trochlear inclination,trochlear depth,trochlear angle,and sulcus angle,in cases of PI.In addition,we reviewed the evaluation of coronal alignment,femoral anteversion,and tibial torsion.Possible causes of error that can be made when evaluating these factors are examined.PI is a multi-factorial problem.Many problems affecting bone structure and muscles morphologically and functionally can cause this condition.It is necessary to understand normal anatomy and biomechanics to make more accurate radiological measurements and to identify causes.Knowing the possible causes of measurement errors that may occur during radiological measurements and avoiding these pitfalls can provide a more reliable road map for treatment.This determines whether the disease will be treated medically and with rehabilitation or surgery without causing further complications.

Radiological evaluation of patellofemoral instability and possible causes of assessment errors:Letter to the editor

This letter to the editor is a commentary on the study titled"Radiological evaluation of patellofemoral instability and possible causes of assessment errors".There are some pertinent structural changes and radiological findings that should be considered in the setting of traumatic knee injuries,as their recognition is of paramount importance.

Therapeutic potential of ethyl acetate fraction of Tephrosia purpurea Linn.leaves in a rat model of gout

Objective: The present study is to determine the potential treatment effects of ethyl acetate fraction of Tephrosia purpurea Linn. leaves(EATP) against gout.Methods: Gout in experimental rats was induced with potassium oxonate at the dose of 250 mg/kg(intraperitoneal injection) for 7 consecutive days;EATP was administered 1 h after administration of the potassium oxonate on each day of experiment. Potassium oxonate was discontinued on the 8 th day;thereafter allopurinol(10 mg/kg, p.o.) and EATP(200 and 400 mg/kg, p.o.) were continued until day 14. The uric acid level was measured from serum and urine during the experiment. Other biochemical parameters were assessed, including blood and urine creatinine, erythrocyte sedimentation rate, and total protein. Blood urea nitrogen, serum aspartate aminotransferase serum alanine aminotransferase and alkaline phosphatase were also measured. The blood was analyzed for levels of malondialdehyde and the antioxidant enzymes such as superoxide dismutase, catalase and glutathione peroxidase.Histopathological and radiological changes in the ankle of rats were observed after completion of the experiment.Results: EATP was able to decrease serum uric acid and creatinine level;it also reduced inflammation,oxidative stress and lysosomal enzyme level, which has a role in acute inflammation. EATP increased uric acid excretion through urine due to its uricosuric effect.Conclusion: EATP lowered the serum uric acid level and increased the urine uric acid level through excretion, which is useful in the treatment of gout. Hence the EATP was found to be helpful in the treatment of gout.