How is patellofemoral pain syndrome diagnosed?

The doctor will first take a history from the patient to learn about the location of the pain, when it began, and whether it is injury-related. Knowing the patient's activity level, whether there is instability, and what motions increase pain help the doctor make the diagnosis.

In the physical examination the doctor will:
  • usually be able to reproduce the symptoms by pressing on the kneecap, particularly when the knee is bent and then straightened.
  • check for tenderness and patellar motion
  • assess alignment and flexibility
  • evaluate the muscular strength and coordination of the leg
X-rays show the bony structures of the knee, permitting the doctor to rule out:
  • arthritic conditions
  • loose bodies (bone fragments in the joint)
  • patellar mal-alignment
  • varus or valgus mal-alignment (bow-legs or knock-knees)
  • infection or a bone tumor
An MRI (Magnetic Resonance Imaging) or TEC (Technician 99 Radioisotope) Scan may be recommended if symptoms persist after conservative (non-operative) treatment. Both of these studies can show bone changes such as:
  • a bone bruise or stress fracture
  • cartilage loss or deterioration
  • infection or a tumor
An MRI can also reveal:
  • the condition of the ligaments, cartilage, and menisci
  • a swollen plica (a normal fold of tissue which can be painful when it becomes inflamed and enlarged).
  • Tendonitis or partial tearing with nodule formation in the patellar tendon

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