Patellofemoral syndrome: Difference between revisions
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Revision as of 18:14, 7 July 2016
Background
- Major cause of anterior knee pain (especially in women)
- Pain comes from contact of posterior surface of patella with the femur
- 3 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
- Press patella away from femoral condyles while patient contracts the quadriceps
Diagnosis
- Knee XR series- patella may not line up with groove of the femur on sunrise view, decreased space posterior to patella, bony erosions
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
Management
- Conservative therapy (w/ emphasis on physical therapy and strengthening)