Patellofemoral pain

1. What is patellofemoral pain?
2. What is the presentation of patellofemoral syndrome?
3. What conditions predispose to PF syndrome?
4. What imaging is required for PF syndrome?
5. What is the nonsurgical treatment of PF syndrome?
6. What are surgical options for PF syndrome?

Answers:
1. Overuse injury caused by repeated microtrauma leading to peripatellar synovitis.
2. Presentation is as anterior knee pain w/wo effusion or crepitus, worse with stairs.
3. High riding, laterally shifted patella, which may be due to VL tightness and relative medial weakness, tight lateral retinaculum, rotation of patella, tight hip flexors or abductors or hamstrings, increased Q angle.
4. X-ray to assess patella position. MRI not useful, CT used if growth plate involvement or tumor is suspect.
5. Use ice and NSAIDs in acute phase, patellar taping and bracing, therapy including strengthening of VMO, stretching of hamstrings, IT band, adductors, and VL, proprioceptive exercises.
6. Surgical options are lateral release of retinaculum, patellar realignment, patellar tendon transfer, patellectomy. Consider surgery if no improvement after 4-6 mo.
7.