Patellofemoral pain syndrome
| Patellofemoral pain syndrome | |
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| Diagram of the bones of the lower extremity. Rough distribution of areas affected by PFPS highlighted in red: patella and distal femur. | |
| Classification and external resources | |
| Specialty | Orthopedics, sports medicine |
| ICD-10 | M22.2 |
| ICD-9-CM | 719.46 |
| DiseasesDB | 33163 |
| eMedicine | article/308471 |
| Patient UK | Patellofemoral pain syndrome |
| MeSH | D046788 |
Patellofemoral pain syndrome (PFPS) is a syndrome characterized by knee pain ranging from severe to mild discomfort seemingly originating from the contact of the posterior surface of the patella (back of the kneecap) with the femur (thigh bone). It is "anterior knee pain involving the patella and retinaculum that excludes other intraarticular and peri-patellar pathology".
The population most at risk from PFPS are runners, cyclists, basketball players and other sports participants. Onset can be gradual or the result of a single incident and is often caused by a change in training regime that includes dramatic increases in training time, distance or intensity, it can be compounded by worn or the wrong type of footwear. Symptoms include discomfort while sitting with bent knees or descending stairs and generalised knee pain. Treatment involves resting and physical therapy that includes stretching and strengthening exercises for the legs.
PFPS is one of a handful of conditions sometimes referred to as runner's knee; the other conditions being Chondromalacia patellae, Iliotibial band syndrome, and Plica syndrome.
Chondromalacia patellae is a term sometimes treated synonymously with PFPS. However, there is general consensus that PFPS is a term that applies only to individuals without cartilage damage, thereby distinguishing it from chondromalacia patellae, a condition characterized by softening of the patellar articular cartilage. Despite this academic distinction, the diagnosis of PFPS is typically made clinically, based only on the history and physical examination rather than on the results of any medical imaging. Therefore, it is unknown whether most persons with a diagnosis of PFPS have cartilage damage or not, making the difference between PFPS and chondromalacia theoretical rather than practical. It is thought that only some individuals with anterior knee pain will have true chondromalacia patellae.
The onset of the condition is usually gradual, although some cases may appear suddenly following trauma.
In most patients with PFPS an examination of their history will highlight a precipitating event that caused the injury. Changes in activity patterns such as excessive increases in running mileage, repetitions such as running up steps and the addition of strength exercises that affect the patellofemoral joint are commonly associated with symptom onset. Excessively worn or poorly fitted footwear often contribute. To prevent recurrence the causal behaviour should be identified and managed correctly.
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Wikipedia