Diagnostic Approach for Patellofemoral Malalignment

Imaging Recommendations

• Weight-bearing axial radiographs are the gold standard for demonstrating the degree of patellar tilt or subluxation and provide superior assessment of patellofemoral kinematics compared to clinical examination, as recommended by the American College of Radiology 1, 2
• CT is the most commonly used modality for measuring axial malrotation when detailed assessment is required, particularly in post-arthroplasty patients, according to the American College of Radiology 1, 3
• Weight-bearing views should not be skipped, as non-weight-bearing radiographs underestimate functional malalignment, as stated by the American College of Radiology 1, 2