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Author Topic: Patellofemoral Syndrome - coming to a diagnosis  (Read 4630 times)

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Iona_-Uk

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Re: Patellofemoral Syndrome - coming to a diagnosi
« Reply #1 on: July 17, 2002, 12:13:47 PM »
Aaarggghh. PFS, the bain of many peoples lives.

I was 13 when I was diagnosed and the diagnosis was made purely on touching me knee, if I remember correctly.

I said to the os- I'm in pain everytime I move my knee and walking any distance is a struggle and painful for hours afterwards. I remember him saying "Let me feel your knee" (it was only my right one at the time) and he touched my knee and said "Yes exactly what I thought, PFS".

I never knew you could make a diagnosis like that and later on I found out I didn't have PFS at all, I was mal tracking but did they spot this, no had to wait 3 years.

I think dr's may be to quick to blame PFS for pain when it could be something else but not quick or exerperienced enough to dianose it if  patient is really suffering badly with PFS.

I've read so many times that PT will help PFS in many cases but what about PT making symptoms worse because the patient doesn't have PFS? I found my knee was significantly worse with physio because she was giving me all the wrong exercises.

Iona :o

Offline rhea

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Re: Patellofemoral Syndrome - coming to a diagnosi
« Reply #2 on: July 17, 2002, 08:01:50 PM »
KNEEguru can you supply us with a definition of patello femoral syndrome (aka pfs)?  I thought that PFS was a general name used to cover any knee problem involving the patella and the femoral groove not functioning properally.  I always thought PFS included mal tracking...  

Yes Iona, I've read all of those statistics on PFS too!  Like 80% of people with it get better with braces, PT, and orthotics.  I think for the most part this may be true.  I have three cousins who had/have pfs and got back as good as new to there usual activities after PT,braces, and some shoe inserts.  I've done all of those and more 3X over and found like you to get worse and worse.  The only thing that's helped me is the Breg PTO.  Now if the Breg PTO brace has helped this much than there has to be some maltracking going on, despite those xrays.  Oh and does anyone else notice if they are tense there knee caps don't click, clunk, or grind as much?  Mine always do that and its frusterating because when Im seeing an OS I am always tense, so the knee caps don't do there usual thing, and than the OS thinks Im just making it up.  Arrghhh!!  

I hope everyone else is doing okay!

rhea  
7 yrs of knee troubles (maltracking, maybe plica).  
Finally found wonderful OS(#4)!
Diagnostic scope+biopsy schduled for sept 23,2003  
HMS/EDS III
Chronic joint pain,subluxations,microtraumas...

Offline Grace

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Re: Patellofemoral Syndrome - coming to a diagnosi
« Reply #3 on: July 17, 2002, 11:00:18 PM »
Yes Rhea!  I know exactly what you mean.  I have been scared of docs since i was little (i have not been in that great of health my entire life)because i never got good news from them.  So i am always really tense when i see the doc!  Its kind of like a car that makes a wierd noise...as soon as you bring it into the shop, it stops making the noise!

What is the difference between PFS and mal-tracking?  When igave up after four years and went in for help, my doc said i had chrondromalacia and the PT said my pain was coming from PFS.  But it seems there was a point that we stopped treating the PFS or he decided that it wasn't the prob.  Now is says i am tracking laterally and i am still in a great deal of pain (don't ask me to walk far, drive long, or even try stairs), and he has referred to mal-tracking a few times.

tired of trying to decode the people that are supposed to be helping!  You are right Rhea...things will only become clear and we will get allthe answers when we become OS's and treat ourselves!  It actually makes me really think about becoming  a PT or a PTA....to help people who are in the same place we are.

I am really frustrated cause i am not feeling any better.
But i hope everyone out there in the "knees suck" community is feeling great and enjoying nice weather...sun on your shoulders is a great cure!
                                                               - Grace -
8 months of continuous physical therapy
plica excision/ shaving 6-10-02
5 months of agressive physical therapy
modified Fulkerson and lateral release 5-13-03
currently in limbo

Offline noddy

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Re: Patellofemoral Syndrome - coming to a diagnosi
« Reply #4 on: July 18, 2002, 10:21:31 AM »
I have had PFS for over 4 years. Had a lateral release 2 years ago to supposedly solve the problem. It never got any better, only worse.  I went to see a new OS this year.  He performed an arthroscopy and discovered that I have no cartilage at all under one side of my patella and what they call a kissing lesion on one of my knee bones.(Don't remember which one) This would have been evident when the first surgeon did the LR but he never said a word about it.

I am having an ACI in 4 weeks time. This process will hopefully give me some pain relief for a few years at which time I will probably need a knee reconstruction.

It pays to get a second opinion if you are getting no answers from the doctor you are seeing.

Offline The KNEEguru

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Re: Patellofemoral Syndrome - coming to a diagnosi
« Reply #5 on: July 27, 2002, 01:20:56 AM »
Regarding a definition of PFS - all the terminology of patellar problems seems to be in a muddle and the muddle never seems to get any better.

A 'syndrome' means a collection of symptoms which seem to have a relationship to one another. 'Patello-femoral', as you all know' means relating to the joint of the kneecap and the underlying thighbone.

To me, 'patello-femoral syndrome' means rather loosely 'the collection of symptoms - such as anterior knee pain (pain in the front of the knee), crunching noises, discomfort with stairs, discomfort with sitting in certain positions for a long time - which indicate that there is something wrong under the kneecap. I don't think of it as a specific diagnosis - only a collection of symptoms indicating that something is wrong.

To others, 'patellofemoral syndrome' is more definite than that - being the collection of subtle factors which lead to maltracking, thus distinguishing it from less subtle things like a plica.

Chondromalacia is another word which has different meanings to different people.  Medically the word means 'softening of the cartilage of the joint surface'.  Most knee surgeons now reserve the term for a description of the softening they can see and feel (with a probe) at arthroscopy (keyhole surgery) - and do not use this term as a diagnosis.  Many different things can cause this softening, so it is a 'sign' of a problem, rather than a diagnosis in its own right.
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Iona_-Uk

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Re: Patellofemoral Syndrome - coming to a diagnosi
« Reply #6 on: July 27, 2002, 11:08:15 PM »
The second (locum) orthpaedic surgeon I saw seemed to think PFS and chrondromalcia were the same thing.

I said to him "Whats wrong with my knee?" "Its PFS" "So not chrondromalcia then?""My dear they are the same thing".

It would be better if someone could set universal guidelines for PFS? KNEEguru maybe?

Iona

Offline Broce

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Re: Patellofemoral Syndrome - coming to a diagnosi
« Reply #7 on: July 31, 2002, 08:22:43 PM »
Quote
The second (locum) orthpaedic surgeon I saw seemed to think PFS and chrondromalcia were the same thing.

I said to him "Whats wrong with my knee?" "Its PFS" "So not chrondromalcia then?""My dear they are the same thing".

It would be better if someone could set universal guidelines for PFS? KNEEguru maybe?

Iona


Iona, these conditions are certainly not interchangable. I've had a LR and most recently an arthroscopy to clean out scar tissue. I most definitely have PFS (let's not talk about stairs...or pain!), but my cartilage, according to my OS is in "very good shape for a woman your age, period). I'm almost 44, arthritis runs in my family, and due to the injury, I figured the cartilage was probably a real problem. According to the doctor, it's more than fine.

Next step for me is a bone scan, to see if the PFS is being caused by friction on the bone...and then a possible TTT (which I think I would like to avoid).

Good luck!  :)
Through the trees,
Broce

Iona_-Uk

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Re: Patellofemoral Syndrome - coming to a diagnosi
« Reply #8 on: July 31, 2002, 11:34:03 PM »
Hi Broce

I've had nearly the same surgery as you, see below. I also have lovely cartilidges as my os says but I have rheumatoid arthristis too (gladly at the moment confined to my right hip and wrist and 4 fingers).

I've not had much luck with my previous surgeon although my current one is the best and most knowledgable I have come across and I feel lucky to have found someone with the knowledge to tell me what is wrong.

I have come to face fact that I will suffer with my knees but I'm hoping they will get better.

Good luck with your scan.
Iona















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