Diagnostic Tests For Chondromalacia
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From WebHealth
Diagnostic Tests For Chondromalacia
Chondromalacia usually is a clinical diagnosis where the physician examines the patient. Occasionally, there might be reasons to do an MRI scan because the joint tenderness in the medial aspect of the knee is so pronounced that the physician suspects a medial meniscus tear.
However, to the surprize of everybody the MRI scan that may have been ordered, shows a chondromalacia of the patella and also chondromalacia of the adjacent femoral bone (the inside articulating part of the lower thigh bone). In this case an arthroscopy is usually not necessary.
On the other hand, the patient may have been booked already for an arthroscopy without the benefit of a prior MRI scan. The surgeon might find surprisingly that there is chondromalacia, but no meniscal tear.
If there is grade III or IV chondromalacia, the surgeon may have to shave off any irregularities on the joint surface, although the literature regarding this is not convincing that this is effective on the longterm. However, it may give the patient some symptom relief from the knee pain for a year or two. Ultimately this turns into knee arthritis and a total knee replacement would have to be considered a few years further down.
X-rays are of no use as the hyaline cartilage does not show up on X rays except for grade IV chondromalacia indirectly as a slight joint narrowing. However, at that time there is palpable crepitation (=grinding) in the joint.
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References:
1. The Merck Manual, 7th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapter 62.
2. EL Cain et al. Clin Sports Med 2001 Apr;20(2):321-342.
3. B. Sears: "Zone perfect meals in minutes". Regan Books, Harper Collins, 1997.
3. Goldman: Cecil Textbook of Medicine, 21st ed.(©2000)W.B.Saunders
4. Ferri: Ferri's Clinical Advisor: Instant Diagnosis and Treatment, 2004 ed., Copyright © 2004 Mosby, Inc.
5. Rakel: Conn's Current Therapy 2004, 56th ed., Copyright © 2004 Elsevier
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