Anterior knee pain worse with stairs / squatting (patellofemoral pain)
Recommended: Clinical diagnosis; X-ray (sunrise view) + MRI for refractory is an acceptable imaging study for anterior knee pain worse with stairs / squatting (patellofemoral pain). Multifactorial: malalignment, muscle imbalance, cartilage degeneration.
Recommended study
Clinical diagnosis; X-ray (sunrise view) + MRI for refractory
Multifactorial: malalignment, muscle imbalance, cartilage degeneration. Imaging excludes structural pathology.
If the default doesn't apply
Patellar instability / dislocation history
MRI
MRI Knee + measure TT-TG distance
No contrast
Watch-outs
Patellar instability is different entity
Recurrent dislocations need anatomic assessment (TT-TG, trochlear dysplasia, MPFL injury).
Pearls
- TT-TG (tibial tubercle-trochlear groove) distance > 20 mm = abnormal.
- Trochlear dysplasia classification (Dejour A-D).
- Conservative management first-line; MPFL reconstruction for recurrent instability.