Plica syndrome is a collection of symptoms commonly experienced together when a fold of joint lining called a plica is irritated, thickened and intermittently catches in the joint.

Page updated November 2023 by Dr Sheila Strover (Clinical Editor)

site of pain from a synovial plica on the medial side of the knee
Photograph of the typical quadrant of the knee where the patient experiences dull pain, occasional sharp catching pain and the examiner can roll under the fingers a thickened tender band.

 

How does a plica become irritated?

A patient with symptoms suggestive of plica syndrome may remember a blunt injury like a direct blow or a fall on the knee, after which any repetitive stress - like descending steps - may trigger discomfort.

During arthroscopy it may be possible to visualise the thickened medial plica snapping over the femoral condyle, opening up a fissure of underlying damage to the cartilage surface at that exact point.

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The mechanism of medial plica trauma

In this illustration and arthroscopic photo you can see a medial plica being nipped between patella and femur during joint movement. Above the knee a different synovial fold - the suprapatellar plica - may become nipped between the femur and the quadriceps tendon.

 

medial plica catching in joint - plica syndrome

plica catching between bones - plica syndrome

Photograph taken during keyhole surgery. As the plica thickens such nipping (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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Forum discussions

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Synonyms: 
medial plica irritation
synovial plica syndrome
medial plica syndrome
lateral plica syndrome
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Dr Sheila Strover (Editor)
BSc (Hons), MB BCh, MBA

See biography...


Relevant material -


 

eBook about plica problems in the knee

eBook - An overview of plica problems in the knee

by - Dr Lars Blønd

An expert look at the various plical folds of the knee and the problems that can be caused by a troublesome plica.


eBook about common knee symptoms

eBook - Common Knee Symptoms

by Dr Sheila Strover

An easy-to-follow discussion of the more common symptoms experienced in the knee.