Plica syndrome

The person may experience discomfort in a particular quadrant of the front of the knee - with dull pain, occasional sharp catching pain and a thickened tender area in that same distribution.

Situation of discomfort in Plica Syndrome

Discomfort is typically felt on the inner aspect of the knee. A medial plica may be palpable as a tender cord-like structure on the lower inner quadrant of the knee.

 

This medial plica is being nipped between patella and femur during joint movement. Above the knee the suprapatellar plica may become nipped between the femur and the quadriceps tendon.

Such trauma can cause the tissue fold to become inflamed and thickened, and then nippling (catching) can occur more often.

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Management of Plica Syndrome

Different plicae can cause different symptoms - the common problematic plica is located on the medial (inner) aspect of the knee and it can become traumatised between the bones.

Treatment may includes anti-inflammatory medication, local steroid injection, physiotherapy to strengthen the quadriceps and hamstrings muscles and arthroscopic surgery to remove the structure entirely.

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Quick links

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Forum discussions

• Hughstons Plica Test

  A patient explains the Hughston plica test.

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Peer-reviewed papers

• Quote:

  "A diagnosis of SPS [synovial plica syndrome] should be suspected in patients with intermittent pain, swelling, and snapping sensation affecting the knees, which is associated with activity that involves increased loading of the patellofemoral joint."

  Citation: Lee PYF, Nixion A, Chandratreya A, Murray JM. Synovial Plica Syndrome of the Knee: A Commonly Overlooked Cause of Anterior Knee Pain. Surg J (N Y). 2017 Feb 15;3(1):e9-e16. doi: 10.1055/s-0037-1598047. PMID: 28825013; PMCID: PMC5553487.

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