Patellofemoral syndrome: Difference between revisions

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==Background==
==Background==
[[File:Knee diagram2.png|thumb|Anatomy of anterolateral aspect of right knee.]]
*Also known as "Runner's Knee"
*Major cause of anterior knee pain (especially in women)
*Major cause of anterior knee pain (especially in women)
**Pain comes from contact of posterior surface of patella with the femur
**Pain comes from contact of posterior surface of patella with the femur
*3 major causes:
*Term Chondromalacia patella typically used synonymously, however this term implies softening of the cartilage
**1. Focal trauma (least common)
 
**2. Overuse
===Major Causes===
**3. Abnormal patellar tracking (due to quadriceps weakness)
#Focal trauma (least common)
#Overuse
#Abnormal patellar tracking (due to quadriceps weakness)


==Clinical Features==
==Clinical Features==
*Gradual onset of unilateral, anterior knee pain, nonradiating
*Gradual onset of unilateral, anterior knee pain, nonradiating
*Pain worsened by prolonged knee flexion ("moviegoer syndrome") and stair climbing
*Pain worsened by prolonged knee flexion ("moviegoer syndrome") and stair climbing
*Patellar grind test
**Press patella away from femoral condyles while patient contracts the quadriceps
***Sudden patellar pain and relaxation of the muscle is positive test


==Diagnosis==
===Patellar grind test===
*Knee XR series- patella may not line up with groove of the femur on sunrise view, decreased space posterior to patella, bony erosions
*Press patella away from femoral condyles while patient contracts the quadriceps
*Sudden patellar pain and relaxation of the muscle is positive test


==Differential Diagnosis==
==Differential Diagnosis==
{{Knee DDX}}
{{Knee DDX}}
==Evaluation==
*Knee XR series
**Patella may not line up with groove of the femur on sunrise view
**Decreased space posterior to patella
**Bony erosions


==Management==
==Management==
*Conservative therapy (w/ emphasis on physical therapy and strengthening)
*Conservative therapy (with emphasis on physical therapy and strengthening)
 
==Disposition==
*Outpatient management


==See Also==
==See Also==
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[[Category:Orthopedics]]
[[Category:Orthopedics]]
[[Category:Sports Medicine]]

Latest revision as of 21:44, 21 May 2020

Background

Anatomy of anterolateral aspect of right knee.
  • Also known as "Runner's Knee"
  • Major cause of anterior knee pain (especially in women)
    • Pain comes from contact of posterior surface of patella with the femur
  • Term Chondromalacia patella typically used synonymously, however this term implies softening of the cartilage

Major Causes

  1. Focal trauma (least common)
  2. Overuse
  3. Abnormal patellar tracking (due to quadriceps weakness)

Clinical Features

  • Gradual onset of unilateral, anterior knee pain, nonradiating
  • Pain worsened by prolonged knee flexion ("moviegoer syndrome") and stair climbing

Patellar grind test

  • Press patella away from femoral condyles while patient contracts the quadriceps
  • Sudden patellar pain and relaxation of the muscle is positive test

Differential Diagnosis

Knee diagnoses

Acute knee injury

Nontraumatic/Subacute

Evaluation

  • Knee XR series
    • Patella may not line up with groove of the femur on sunrise view
    • Decreased space posterior to patella
    • Bony erosions

Management

  • Conservative therapy (with emphasis on physical therapy and strengthening)

Disposition

  • Outpatient management

See Also

References