Patellofemoral pain - course
Dr Ronald Grelsamer is an associate clinical professor at the Mount Sinai Hospital in New York.
He has decades of experience in managing problems of the knee related to the patella. In this course he gives a comprehensive overview of those conditions that can cause pain in the patellar region.
Page first published 2008, and reviewed August 2023 by Dr Sheila Strover (Clinical Editor)
- Patellofemoral pain
- Patellofemoral Anatomy
- Important patellofemoral concepts
-
Differential diagnosis of patellofemoral pain
- Conditions interfering with patellofemoral mechanics
- Conditions causing patellofemoral pain but NOT interfering with the mechanics of the knee
- Symptoms associated with patellofemoral pain
- Examination in cases of patellofemoral pain
- Imaging and X-rays for patellofemoral pain
- Non-operative treatment for patellofemoral pain
- Surgery for patellar malalignment
- Surgery to slow established patellofemoral arthritis
- Patellofemoral pain - Glossary
Pain around the knee cap (patella) will not develop without a cause.
Although you may have been told that you have 'chondromalacia' or that you suffer from 'patellofemoral syndrome', these terms actually encompass a wide variety of conditions. In this Part of the course I will run briefly through the list of some of these conditions.
Conditions interfering with the mechanics of the knee
Tight structures around the knee
- Tight lateral retinaculum (patellar tilt and/or lateral displacement)
- Tight ilio-tibial band
- Tight hamstrings
- Tight quads
- Tight calf muscles
- Patellar arthrofibrosis & patella baja
Loose structures around the knee
- constitutional laxity (hypermobility syndromes)
- patella alta (high knee caps)
Factors increasing the Q angle
- Flat feet
- Knock knees (valgus deformity)
- Poorly positioned tibial tubercle
- Tibial rotation (including 'miserable malalignment')
Irritation of soft tissues inside the knee
- Plica syndrome
- Fat pad syndrome
- Pre-patellar & infra-patellar bursitis
- Synovial impingement
- Neuroma in the lateral retinaculum
- Early rheumatological conditions
Overuse
- Unusual exercise
- Patellar tendinopathy
- Quadriceps tendinopathy
Deformed bones
- Trochlear dysplasia
- Patellar dysplasia
- Bipartite patella
- Dorsal defect
Stressed bones
Knee problems not necessarily involving the mechanics of the knee
- Neuroma under the skin
- Osteochondritis dissecans
- Tumors
- Infection
'Complex Regional Pain Syndrome'
I will go into this in more detail later.
'Referred Pain', not originating with the knee at all
- Hip problem, e.g. slipped capital epiphysis
- Spine problem
This list is for reference and completes this part of the course. I'll explain all the terms as we go along - don't worry!
PREVIOUS PART: Important patellofemoral concepts
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Relevant site material -
- SITE HOMEPAGE
- patellar tilt
- ilio-tibial band syndrome
- arthrofibrosis
- patella baja
- hypermobility syndrome
- patella alta
- flat feet
- valgus deformity
- miserable malalignment
- plica syndrome
- fat pad syndrome
- prepatellar bursitis
- infrapatellar bursitis
- trochlear dysplasia
- patellar dysplasia