The Contribution of Instrumental and Imaging Technologies to the Diagnosis And/or Treatment of Clinical Problems Associated with the Knee.

Aspects of Medical Engineering

The Contribution of instrumental and imaging technologies to the diagnosis and/or treatment of clinical problems associated with the knee.

Abstract:

Clinical problems of the knee can be diagnosed using instrumentation and imaging technologies. This is an important aspect as it identifies the specific disease and enables the application of the correct treatment.

Imaging techniques include: X-ray, which illustrates abnormalities in bones. MRI scan, which create 3-dimensional pictures of blood vessels. And finally, CT scan, which creates cross sectional pictures of the body.

An example of instrumental technology would be the arthroscope, where a small camera is inserted into the knee to examine internal tissues.

There are many other ways of approaching clinical problems associated with the knee, for example, implants for soft and hard tissues, rehabilitation, and tissue engineering.

Introduction

"The knee is the most commonly injured joint in the body...most injuries to the knee involve either the patellofemoral joint, a ligament strain, or a cartilage tear."

- Dr Chris Milne (http://www.medic8.com/healthguide/articles/kneeinjuries.html)

Clinical problems associated with the knee are approached in one specific manner: diagnosis and treatment.

The problem is first diagnosed to identify the specific disease associated with the knee. Using these results, the problem will then be treated in an appropriate manner.

Diagnosis and treatment of clinical problems associated with the knee can be broken down into several subdivisions: implants for soft and hard tissues, rehabilitation technologies, instrumentation and imaging technologies, and tissue engineering.

This report will look into instrumentation and imaging technologies in more detail, and how it has contributed to the diagnosis and treatment of problems linked to the knee.

Common knee injuries and problems

Arthritis:

The most common form of arthritis of the knee is osteoarthritis. This is when the cartilage gradually wears away and is normally caused by excessive strain on the knee joint due to deformity, repeated injury or excess weight.

Osteoarthritis commonly affects middle-aged and older people. However, if young people develop osteoarthritis then it is likely to be an inherited form of the disease or is due to continuous irritation from a persistent injury of the knee.

Another common form of arthritis that affects the knee is known as rheumatoid arthritis. This is an autoimmune disease i.e. it occurs as a result of the immune system attacking components of the body. In rheumatoid arthritis, the main site of the immune system's attack is the synovium and causes inflammation of the knee joint. It can lead to the destruction of cartilage, bone, muscles, tendons and ligaments.

Chondromalacia:

This is the softening of articular cartilage of the patella and occurs mostly in young adults. Injury, overuse, misalignment of the patella and muscle weakness all contribute to this disease.

In chondromalacia, the patella rubs against the lower end of the thighbone instead of gliding smoothly over it. This results in the roughening of the cartilage underneath the patella, which can lead to significant damage ranging from a slightly abnormal surface of the cartilage to a surface that has been worn away to the bone.

Meniscus injuries:

The meniscus is commonly injured due to a rotation of the knee whilst bearing weight. The injury ranges from a partial tear to a total tear. With a partial tear, the meniscus stays connected to the front and back of the knee. But with a large tear, the meniscus is left hanging by a thread of cartilage.

Ligament injuries:

An injury to the anterior cruciate ligament (ACL) is most often caused by a sudden twisting motion, which may stretch or even tear the ligament. The posterior cruciate ligament (PCL) on the other hand, is normally injured via a direct impact.

A medial collateral ligament (MCL) or lateral collateral ligament (LCL) injury is commonly caused by a direct blow to the outside of the knee that stretches and tears the ligament on the inner side of the knee. The MCL tends to be more easily damaged than the LCL.

Tendon injuries and disorders:

Knee tendon injuries range from tendonitis (inflammation of the tendon) to a ruptured tendon. Tendonitis usually occurs due to excessive use of the tendon, causing it to wear out and become inflamed. This type of injury normally occurs to older people who have weaker tendons.

Osgood-Schlatter disease:

This disease normally occurs in active children ranging from an age of ten to fifteen years. It is caused by repetitive stress or tension on part of the growth area of the upper tibia.

Osteochondritis dissecans:

This occurs due to a lack of blood supply to an area of bone underneath a joint surface. The affected bone and its covering of cartilage gradually loosens and cause pain. The disease is often found in an active adolescent and the condition can eventually develop into osteoarthritis.

Medical imaging

Imaging techniques may be defined as methods of visual screening display of internal features of the body, examples include X-rays, MRI and CT scans. These techniques are often used to assist the diagnosis of clinical problems, and such imaging technology has been growing at a rapid pace since the 1960's due to the availability of faster, more powerful computers. However, medical imaging has also been criticized broadly due to its heavy health costs.

X-Rays

X-rays were discovered by a W. Roentgen in 1895, and it is the most important and widely used diagnostic tool in clinical medicine.

X-rays are a form of electromagnetic radiation that can be used to detect abnormalities in bones, such as fractures, tumours or degenerative conditions.

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