Best X-rays for Patellar Tracking Assessment

Recommended Radiographic Views for Patellar Tracking

Axial (tangential) radiographs demonstrate the degree of patellar tilt or subluxation and are the primary radiographic method for assessing patellar tracking, according to the American College of Radiology 1, 2
Weight-bearing axial radiographs provide superior assessment of patellofemoral kinematics compared to non-weight-bearing views, as recommended by the American College of Radiology 1, 3
Standing anteroposterior (AP) and lateral views should be included as part of a complete assessment of patellar position and alignment, as suggested by the American College of Radiology 4, 5

Weight-bearing position enhances the evaluation of true functional patellar tracking during load-bearing conditions, according to the American College of Radiology 1, 2
10 degrees of internal rotation improves the interpretation of varus and valgus alignment compared to neutral AP views, as recommended by the American College of Radiology 4, 6

Axial radiographs are particularly useful for evaluating patellar subluxation, tilt, and dislocation in patients with patellofemoral instability, according to the American College of Radiology 1, 3
Axial views are essential for evaluating patellar complications after total knee arthroplasty, including component malposition, as recommended by the American College of Radiology 1, 2

CT scanning can provide more detailed assessment of patellar tracking when X-rays are inconclusive, particularly for measuring axial malrotation of knee prostheses, as suggested by the American College of Radiology 1, 3
MRI with metal artifact reduction can be useful for assessing patellar complications in post-TKA patients when radiographs are inconclusive, according to the American College of Radiology 1