We are currently employing the same methodology to study chondromalacia patella to establish if the shape of the trochlear sulcus of the patella is associated with the risk of patella cartilage degeneration. In cooperation with Simon Fraser University in Canada our group is using related methodology to evaluate the bicepital groove morphology as a predisposition to bicepital tendon disorders. Lastly, we are using erect MR images performed in Israel, comparing the shape and position of the menisci in arthritic patients with nonarthritic patients, and using the methodology to extrapolate contact forces along the articular cartilage. In collaboration with the Siemens laboratory in Princeton, we have studied the shape of the neural foramina of the spine, and the effect of body habitus on this shape, attempting to correlate spinal foraminal shape with patient symptoms. Related to shape analysis is the use of anatomic structures to aid in understanding how dynamic forces affect articulations. We believe that musculoskeletal disorders relate to a combination of shape, degeneration and dynamic vectors. Imaging may play a dominant role in the dynamic analysis. Our preliminary work in the shoulder has revealed that the deltoid muscle has a different insertion in patients with impingement and rotator cuff tears when compared to normal individuals. This implies that the dynamic stresses on the rotator cuff may be more important than the configuration of the outlet, presently the primary criteria for impingement. The work of Kevin Filmore, one of our radiology residents, relates to this observation. Dr. Filmore is measuring the pennation angle, which is the angle that the muscle fibers make with the primary tendon bundle. This measurement may result in an improved metric to evaluate musculoskeletal degenerative disease. Preliminary data in the shoulder bear this out, although in a surprisingly complex way.
We live in an exciting era, one where the understanding of degenerative musculoskeletal conditions is rapidly advancing. The progress made by our NYU musculoskeletal researchers is, indeed, exceptional, and promises advances in the field that may dramatically improve the health of our population. We are proud of their accomplishments.
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