Rotation matters: CT and MRI yield different tibiofemoral rotation angles in patellofemoral patients. An investigational plateau‐anchored MRI method is descriptively associated with a smaller mean CT–MRI difference

Purpose: To compare tibiofemoral rotation (TFR) measured on magnetic resonance imaging (MRI) and computed tomography (CT) in patellofemoral (PF) patients and descriptively report mean differences using an alternative plateau-anchored MRI measurement method. Methods: tests compared TFR between modalities and MRI methods; subgroup analyses evaluated diagnosis. Pearson correlation assessed association between CT-based TFR and tibial torsion. Results: = 0.06). Conclusion: CT and MRI yield systematically different TFR values in the same PF patients; standard MRI yielding lower values than CT. A plateau-anchored MRI method yielded a smaller mean difference relative to CT than the standard MRI method in this cohort. These results should not be interpreted as demonstrating interchangeability, accuracy, or clinical readiness of the plateau-anchored method. Level of Evidence: Level II.