Clinical and radiological assessment of Quadriceps atrophy after acute knee joint injury.


Background: knee injuries is common problem, immobilization of the knee during management of acute injury carry risk of muscle atrophy that have negative impact on regaining preinjury level of strength (1). Aim of study: To minimize the risk of quadriceps muscle atrophy after acute knee joint injury and to detect the early sign of muscle atrophy by using the specific imaging methods to restore the preinjury level of function for the patient when it possible. Methods: prospective cohort study where data collected from outpatient clinic during the period of October 2017to October 2018. Patients selected with acute knee injury who presented within 24 hours, management protocol involved 7 days of immobilization then followed by 6 weeks of rehabilitation program for quadriceps strengthening, the evaluation of muscle wasting include clinical assessment of thigh circumferences and ultrasonography of muscle volume at three different points of time. Statistical analysis undertaken to determine any correlation between atrophy and other variables and the relation between clinical and radiological measurements using chi- square test to determine P. Value.Results: 32 patients, 9 of them were females, with a mean age 29.8 year. The measurement shows significant atrophy after 7 days of immobilization with excellent impact on muscle strength after 6 weeks of rehabilitation when compared the injured with healthy side. Clinical assessment compared to radiological assessment of muscle atrophy. The comparison of the real thigh circumference and ultrasonography readings of the injured limb between the three measurement phases (day 1, day 7 and week 6 after injury) showed significant differences (p< 0.001).Ultrasound measurement comparison of the thigh circumference reading of the injured limb between the three measurement phases (day 1, day 7 and week 6 after injury) showed no significant differences (p= 0.439).Conclusion: Muscle atrophy can occur as early as one week of immobilization after knee injury. Where both clinical and radiological method can be used efficiently to assess muscle atrophy.