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 | ||
* | *Term Chondromalacia patella typically used synonymously, however this term implies softening of the cartilage | ||
===Major Causes=== | |||
#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 | |||
==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 ( | *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
- 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
- Focal trauma (least common)
- Overuse
- 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
- Knee dislocation
- Knee fractures
- Meniscus and ligament knee injuries
- Patella dislocation
- Patellar tendonitis
- Patellar tendon rupture
- Quadriceps tendon rupture
Nontraumatic/Subacute
- Arthritis
- Gout and Pseudogout
- Osgood-Schlatter disease
- Patellofemoral syndrome (Runner's Knee)
- Patellar tendonitis (Jumper's knee)
- Pes anserine bursitis
- Popliteal cyst (Bakers cyst)
- Prepatellar bursitis (nonseptic)
- Septic bursitis
- Septic joint
- DVT
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