Crepitus is a first indication of patellofemoral osteoarthritis (and not of tibiofemoral osteoarthritis)

Osteoarthritis Cartilage. 2014 May;22(5):631-8. doi: 10.1016/j.joca.2014.02.008. Epub 2014 Feb 26.


Objective: The patellofemoral joint (PFJ) is important in early detection of knee osteoarthritis (OA). Little is known about the relationship between specific clinical findings and PFJ Magnetic resonance Imaging (MRI) features. The objective was to examine the relationship between (early) clinical findings and PFJ MRI features in females (45-60 years) without knee OA (PFJ or tibiofemoral joint (TFJ) OA) based on a recently suggested MRI definition.

Methods: MRIs of knees of women of a sub-study of the Rotterdam Study were scored with semi-quantitative scoring. Specific patellar tests were performed on physical examination. Current knee pain and history of patellar knee pain were reported. Binomial logistic generalized estimated equations were used to determine the association between clinical findings of OA and PFJ MRI features. All associations were adjusted for age, body mass index (BMI) and TFJ MRI features.

Results: In 888 women (1776 knees, mean age: 55.1 years and mean BMI: 27.0 kg/m(2)) we found significant associations between crepitus and all PFJ MRI features (Odds ratios (OR) range: 2.61-5.49). A history of patellar pain was significantly associated with almost all PFJ MRI features (ORcartilage: 1.95; ORcysts: 1.86; ORbone marrow lesions: 1.83), except for osteophytes. No significant associations were found between the clinical findings and TFJ MRI features.

Conclusion: Crepitus and history of patellar pain are clinical findings that indicate PFJ lesions seen on MRI. These tests could help to indicate signs of PFJOA. Follow-up data needs to confirm whether these tests have an additional diagnostic value for early knee OA in PFJ or TFJ.

Keywords: Crepitus; MRI; Pain; Patellofemoral osteoarthritis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Body Mass Index
  • Early Diagnosis
  • Female
  • Humans
  • Image Interpretation, Computer-Assisted / methods
  • Magnetic Resonance Imaging / methods
  • Middle Aged
  • Observer Variation
  • Osteoarthritis, Knee / complications*
  • Osteoarthritis, Knee / diagnosis
  • Pain / etiology
  • Patellofemoral Joint / pathology*
  • Physical Examination / methods
  • Sound*
  • Subcutaneous Emphysema / etiology*