Physical Examination and Patellofemoral Pain Syndrome: an Updated Review.

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Abstract

Conflict of interest statement: Donald Kasitinon, Wei-Xian Li, Eric Xue Song Wang, and Michael Fredericson declare that they have no conflicts of interest. 5. Am Fam Physician. 2007 Jan 15;75(2):194-202. Management of patellofemoral pain syndrome. Dixit S(1), DiFiori JP, Burton M, Mines B. Author information: (1)University of California, Los Angeles, Los Angeles, California, USA. Summary for patients in Am Fam Physician. 2007 Jan 15;75(2):204. Patellofemoral pain syndrome (PFPS) is the most common cause of knee pain in the outpatient setting. It is caused by imbalances in the forces controlling patellar tracking during knee flexion and extension, particularly with overloading of the joint. Risk factors include overuse, trauma, muscle dysfunction, tight lateral restraints, patellar hypermobility, and poor quadriceps flexibility. Typical symptoms include pain behind or around the patella that is increased with running and activities that involve knee flexion. Findings in patients with PFPS range from limited patellar mobility to a hypermobile patella. To confirm the diagnosis, an examination of the knee focusing on the patella and surrounding structures is essential. For many patients with the clinical diagnosis of PFPS, imaging studies are not necessary before beginning treatment. Radiography is recommended in patients with a history of trauma or surgery, those with an effusion, those older than 50 years (to rule out osteoarthritis), and those whose pain does not improve with treatment. Recent research has shown that physical therapy is effective in treating PFPS. There is little evidence to support the routine use of knee braces or nonsteroidal anti-inflammatory drugs. Surgery should be considered only after failure of a comprehensive rehabilitation program. Educating patients about modification of risk factors is important in preventing recurrence.