Patellofemoral joint (PFJ) disorders encompass a wide spectrum of disease with pathology arising from trauma, instability, overuse, and chronic maltracking. Patellofemoral pathology is one of the most common sources of knee pain and accounts for nearly 25% of all knee related injuries.1, 2, 3, 4, 5 In addition to traumatic injuries, anatomic abnormalities alter PFJ forces and can increase the risk of PF dislocation and/or lead to progressive PF chondrosis.6 These anatomic and biomechanical abnormalities can manifest as PF pain and instability. In order to create a comprehensive and effective treatment plan, appropriate PFJ imaging must be utilized to confirm a diagnosis, identify injured structures, characterize a patient's unique variations in anatomy (ie, trochlear dysplasia), and define the relationships between osseous and soft tissue structures that contribute to aberrant PF mechanics.7,8 Clinicians must also recognize that not all anatomic variants are pathologic (ie, asymptomatic bipartite patella) and imaging findings must always be correlated with the patient's physical examination. Once anatomic and pathologic abnormalities are correlated with the patient's symptoms, an individualized treatment plan that accounts for both biology and biomechanics can be initiated to optimize PF tracking and function. This chapter provides an updated review of relevant imaging studies utilized in the work-up of patients with PF disorders (Table 1) as well as pertinent imaging findings and their implications for treatment.
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