Anterior knee pain - patellofemoral pain

Patellofemoral pain (PFP) is a clinical diagnosis defined by pain around or behind the patella during loading, in the absence of other specific pathology. The aetiology not completely understood.

Demographics 70% younger than 40 years old. In adolescents pain can be linked to periods of rapid growth and in older patients degenerative changes may be present in PFJ. The most consistent risk factors for PFP are lower knee extension strength and being female. PFP presents as gradual onset associated with PF loading activities squatting, climbing stairs, hiking, running. No definitive test. Best is observation of pain during squatting (80% positive) and functional loaded activities.

• Site of pain
• When does patient experience pain
• Pain during squatting.

• No definitive test
• Compare lower limb extension strength
• Squatting- reproduces pain.

• Xray to rule out degenerative joint disease (DJD)
• MRI.

• Patellar tendinosis
• Hoffas pad irritation
• Osgood Schlatters in younger age group
• Iliotibial band syndrome.

Failure of symptoms to settle with time and conservative management.

Refer to Physiotherapy.