MRI imaging of the patella provides information that a plain X-ray cannot. Specifically the MRI allows the doctor to evaluate the articular cartilage under the patella and over the trochlear groove. The doctor can see if there is a lesion of the articular cartilage, and can get a sense of its location, its width and its depth. The presence or absence of such a lesion will affect the treatment offered to the patient.
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The patella is ideally suited for imaging, and when it comes to detecting malalignment the doctor will usually start with plain x-rays. Here the standard of care would be to obtain four X-rays. These would include the so-called AP (front-to-back), the side view (otherwise known as the lateral), the standing tunnel view and the so-called Merchant view – otherwise known sometimes as the axial view or sunrise view.
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Chondromalacia is a term that is commonly used by health professionals – orthopedists, physical therapists, sometimes internists - and in the United States there is even an insurance code for chondromalacia (717.7) - but the fact of the matter is it’s a completely outdated term.
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