Patients with a patellofemoral pain are either in an acute state after a patellofemoral dislocation or are suffering from a chronic anterior knee pain (AKP), whereas AKP might be accompanied by patellar instability without dislocation. Whereas the acute state after a dislocation is mostly clear and its examination limited, the examination of a AKP is much more complex. A profound knowledge of the anatomy, the painful structures and patellofemoral biomechanics is essential in order to find the underlying pathology within the heterogeneous and diverse etiologies. Furthermore, a meticulous and precise examination is key to find the adequate treatment for AKP.
<p class="abstract"><strong>Background:</strong> Diagnosis of patellofemroal pain syndrome has been challenging due to lack of clinical test with better sensitivity and specificity, axial imaging has been considered as the standard modality for evaluation. Patients with anterior knee pain because of patellofemoral pain syndrome can be sub-grouped as those with or without radiological positive parameter for patellar maltracking. The aim of the present study was to evaluate reliability of clinical tests in two subgroups of patients presenting with patellofemoral pain syndrome<span lang="EN-IN">.</span></p><p class="abstract"><strong>Methods:</strong> 45 knees with anterior knee pain without any episode of patellar instability were evaluated clinically using four standard tests (patellar apprehension test (PAT), eccentric step test (EST), active instability test (AIT) and Waldron’s test. On the basis of CT scan finding (at least one positive radiological parameter of instability) 28 knees were categorized in Group A (potential patellar instability group) and 17 knees in Group B (PFPS).<strong></strong></p><p class="abstract"><strong>Results:</strong> All patients with 3 or more than three clinical test positive were cases with potential patellofemroal instability except two. Whereas other true patellofemroal pain patients all except 2 were have less than 3 positive clinical tests<span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> Clinical test have more diagnostic accuracy in evaluating anterior knee pain due to potential patellofemroal instability in comparison to patellofemroal pain without radiological instability<span lang="EN-IN">.</span></p>
AbstractSynovial plica syndrome (SPS) occurs in the knee, when an otherwise normal structure becomes a source of pain due to injury or overuse. Patients may present to general practitioners, physiotherapists, or surgeons with anterior knee pain with or without mechanical symptoms, and the diagnosis can sometimes be difficult. Several studies have examined the epidemiology, diagnosis, and treatment of SPS. We review these resources to provide an evidence-based guide to the diagnosis and treatment of SPS of the knee.
Progressive anterior knee pain associated with patellar instability in a 57-year-old father and his daughter
