E2152. CT for Patellar Evaluation in Pediatric Patients: A Step-by-Step Approach for the Radiologist
  1. Miguel Aranda Hernandez; National University of Colombia
  2. Claudia Cabarcas; North University
  3. Camilo Mera; National University of Colombia
  4. Wilmer Aponte Barrios; National University of Colombia
Patellofemoral joint stability is a complex process that relies on different factors (bone, ligament and muscle). Patellofemoral instability is a clinical syndrome of unknown cause, high prevalence in young patients, and multifactorial origin due to the complexity of the joint. An adequate radiological and clinical evaluation is necessary for treatment to avoid overload, cartilage deterioration, and subsequent osteoarthritis. Computed tomography improves risk factors analysis, providing objective information on bone parameters and relevant data to the clinician to determine the best treatment.

Educational Goals / Teaching Points
Describe the most practical and useful angles and measurements associated with patellofemoral instability in the pediatric population, create a practical workshop with didactic tools that facilitate the realization and interpretation of angles and measurements, design a structured report model for patellar tomography in the pediatric population that is useful for specialists, and propose a tomographic acquisition protocol with radiation dose optimization taking into account the ALARA principle in the diagnosis of patellofemoral instability in pediatric population.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
We have extensive experience and a high volume of tomographic studies performed for diagnosis of patellofemoral instability in patients treated at a fourth-level pediatric hospital in Bogotá. With an 8-step approach, we propose an evaluation algorithm that takes into account the measurements and parameters most used by the orthopedist for decision of specific treatments. Using colors, angles and pedagogical conventions, the most useful measurements and data will be represented to exemplify the different abnormalities in the diagnosis of patellofemoral instability. A structured report will also be designed describing the most relevant information for the orthopedist when making decisions regarding treatment and facilitating image interpretation for residents and radiologists. By applying our fast and interactive reading method for the interpretation of patellar tomography in the pediatric population, the reading time of these studies will be reduced with noticeable improvements in the results provided.

Computed tomography provides objective bone information and relevant data for the specialist to determine the best treatment in pediatric patients with patellofemoral instability. The design of a fast and interactive reading method for the interpretation of tomography of patellas in pediatric patients will allow time optimization by providing key and useful data for the established treatment.