Little RD, Smith SE, Cicuttini FM, et al. - This study was undertaken to investigate the correlation between patellofemoral geometry and the prevalence of increased signal intensity at the patellar tendon in community-based middle-aged adults. Researchers examined 201 adults aged 25–60 years in a study of obesity and musculoskeletal health. They characterized elevated signal intensity at the proximal patellar tendon as hyper-intense regions of characteristic pattern, size, and distribution on both T1- and T2-weighted sequences. The association between patellofemoral geometrical indices and the prevalence of increased signal intensity at the patellar tendon was analyzed by using binary logistic regression. The evidence suggested that elevated signal intensity at the patellar tendon was common and associated with the Insall-Salvati ratio and patellofemoral congruence angle, suggesting a biomechanical mechanism in community-based asymptomatic middle-aged adults. It was noted that such work is likely to inform tissue engineering and cell regeneration approaches to improving results in those with tendon pathology.