Utrecht Sports Medical Center Utrecht

Utrecht, Netherlands

Utrecht Sports Medical Center Utrecht

Utrecht, Netherlands
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Schoots E.J.M.,Utrecht Sports Medical Center Utrecht | Tak I.J.R.,Physiotherapy Practice Utrecht Oost | Krebbers Y.M.J.,Diakonessenhuis Utrecht | Bax J.G.,Utrecht Sports Medical Center
Journal of Bodywork and Movement Therapies | Year: 2013

Background: Histopathologic changes of the lateral retinaculum are described in patients with patellofemoral pain syndrome (PFPS). No information is available on the presence of structural changes of the lateral retinaculum on ultrasound examination in patients with PFPS. Purpose: To describe ultrasound characteristics and colour Doppler findings in patients with unilateral PFPS and in healthy controls. Methods: 10 patients with unilateral PFPS and 10 healthy control subjects underwent ultrasound and colour Doppler examination of the lateral retinaculum of both knees. Thickness of the lateral retinaculum was measured at three predefined locations. In addition presence of neovascularisation was assessed. Results: Thickness of the lateral retinaculum of both affected (mean [SD] of three locations 4.0 [1.4]mm, 95%CI: 1.2-6.8) and asymptomatic (3.7 [0.8]mm, 95%CI: 2.1-5.3) knees was increased in the patient group compared to the control subjects (3.0 [0.1]mm, 95%CI: 2.8-3.2), although not reaching statistical significance. Positive colour Doppler signals of the lateral retinaculum were found in 4 patients and in none of the control subjects (4/10 versus 0/10; 2×2 Fisher's exact test 1-tailed p=0.0433; 2-tailed p=0.0866; mid p value=0.0217). Conclusions: The results of these measurements indicate a trend towards a larger thickness of the lateral retinaculum and showed neovascularisation measured by ultrasound and colour Doppler examination in patients with PFPS. The larger thickness of the lateral retinaculum on ultrasound examination was found in both affected and in asymptomatic knees of the patients, supporting the concept that PFPS is a bilateral rather than a unilateral disorder. Further research is needed to unravel the role of the lateral retinaculum in pathogenesis of PFPS and to clarify the role of the lateral retinaculum as a target for therapy in patients with PFPS. © 2013 Elsevier Ltd.


Schoots E.J.M.,Utrecht Sports Medical Center Utrecht | Weusten B.L.A.M.,Sint Antonius Hospital
International Journal of Therapy and Rehabilitation | Year: 2012

This case study reports on complaints of midthoracic back pain and dysphagia in a patient with significant osteophytes in the context of Diffuse Idiopathic Skeletal Hyperostosis (DISH). The clinical and radiologic phenomena of DISH are discussed. Despite the presence of important structural radiologic abnormalities in the thoracic spine in our patient, there was a good clinical recovery after exercise and manual therapy aimed at improvement of posture, functional scapulothoracic stability, strength of the interscapular muscles, length of the pectoral muscles, and mobility of the cervicothoracic and upper thoracic spine. We suggest that functional factors rather than structural abnormalities played a causal role in the genesis of midthoracic back pain in our patient.

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