A prospective study of the diagnostic potential of the knee tunnel view radiograph in assessing anterior knee pain

Hing, Caroline; Raleigh, Eden; Bailey, Michael; Shah, Nasir; Marshall, Tom; Donell, Simon; Glasgow, Malcolm

doi:10.1016/j.knee.2006.10.007

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Volume 14, Issue 1 , Pages 29-33, January 2007

A prospective study of the diagnostic potential of the knee tunnel view radiograph in assessing anterior knee pain☆

Caroline Hing
- Department of Orthopaedics, Norfolk and Norwich University Hospital, Norwich NR4 7UY, UK
- Corresponding author. Tel.: +44 1603 286 706; fax: +44 1603 287 498.
- Each author certifies that he or she has no commercial associations and no benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.
- Each author certifies that his or her institution has approved the human protocol for this investigation and that all investigations were conducted in conformity with ethical principals of research, and that informed consent was obtained.
Eden Raleigh
- Department of Orthopaedics, the Alfred Hospital, Monash University, Melbourne, Australia
- Each author certifies that he or she has no commercial associations and no benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.
- Each author certifies that his or her institution has approved the human protocol for this investigation and that all investigations were conducted in conformity with ethical principals of research, and that informed consent was obtained.
Michael Bailey
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
- Each author certifies that he or she has no commercial associations and no benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.
- Each author certifies that his or her institution has approved the human protocol for this investigation and that all investigations were conducted in conformity with ethical principals of research, and that informed consent was obtained.
Nasir Shah
- Department of Orthopaedics, Norfolk and Norwich University Hospital, Norwich NR4 7UY, UK
- Each author certifies that he or she has no commercial associations and no benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.
- Each author certifies that his or her institution has approved the human protocol for this investigation and that all investigations were conducted in conformity with ethical principals of research, and that informed consent was obtained.
Tom Marshall
- Department of Radiology, Norfolk and Norwich University Hospital, Norwich NR4 7UY, UK
- Each author certifies that he or she has no commercial associations and no benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.
- Each author certifies that his or her institution has approved the human protocol for this investigation and that all investigations were conducted in conformity with ethical principals of research, and that informed consent was obtained.
Simon Donell
- Department of Orthopaedics, Norfolk and Norwich University Hospital, Norwich NR4 7UY, UK
- Each author certifies that he or she has no commercial associations and no benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.
- Each author certifies that his or her institution has approved the human protocol for this investigation and that all investigations were conducted in conformity with ethical principals of research, and that informed consent was obtained.
Malcolm Glasgow
- Department of Orthopaedics, Norfolk and Norwich University Hospital, Norwich NR4 7UY, UK
- Each author certifies that he or she has no commercial associations and no benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.
- Each author certifies that his or her institution has approved the human protocol for this investigation and that all investigations were conducted in conformity with ethical principals of research, and that informed consent was obtained.

Received 1 March 2006; received in revised form 4 October 2006; accepted 15 October 2006. published online 28 November 2006.

Abstract

The aim of this comparative study was to examine the potential advantage of the tunnel view radiograph over a series of weight bearing antero-posterior (AP), lateral and skyline radiographs. The study population consisted of 240 subjects with knee pain aged 19 to 93 years. A total of 309 knees had a weight bearing AP in extension, lateral, skyline and tunnel view radiographs. Each radiograph was reported with respect to features related to osteoarthritis, modified from the Ahlback system. Each feature was assessed using the tunnel radiograph alone and then the AP, lateral and skyline views in combination without, and blind to, the information from the tunnel view. On the basis of Bowker's test, the tunnel view was more likely to pick up abnormal intercondylar notch and tibial spine osteophytes but not loose bodies. We conclude that the tunnel view is a valuable addition in the routine assessment of the knee joint in osteoarthritis but not for the diagnosis of loose bodies alone.

Keywords: Knee, Osteoarthritis, Radiography, Osteophytes