patella pain

Introduction

Introduction In the early stage of the tibiofemoral pain syndrome, the knees will be painful when walking, going up and down the stairs, and standing up under the armpits. In severe cases, there will be sudden knees unable to force or even stand unstable during walking. Patellofemoral pain syndrome (PFPS) is a common disease, especially in athletes and women. The cause is not clear, but it has a considerable relationship with the abnormal arrangement of the tibia. There may be a lot of innervation that may be irritated by chemical or stress. Once inflamed, it will cause symptoms when active.

Cause

Cause

Patellofemoral pain syndrome (PFPS) is a common disease, especially in athletes and women. The cause is not clear, but it has a considerable relationship with the abnormal arrangement of the tibia.

The cause of PFSP is not clear, there are two possible arguments:

(1) The humerus deviates from the trochlear groove, so that the tibia is not on the normal trajectory, causing anterior knee pain.

(2) The synovial sac around the humerus is rich in innervation and may be stimulated by chemical or stress. Once inflamed, it will cause symptoms when active.

Examine

an examination

Related inspection

CT examination of thumb and nails for bone and joint and soft tissue

Physical examination:

1. There is a subgingival friction sound when the knee joint is active, and the position is not fixed.

2, there is diffuse pain after the sputum, there is a soft leg phenomenon when walking, the discomfort is obvious when going up and down the stairs.

3, knee joint pain and weakness in the semi-squat, the cheekbone has a tender feeling.

4, tibia compression quadriceps contraction test was positive.

5, humeral pressure test: the examination of the tibia and its opposite femoral condyle joint surface squeezed or rubbed up and down, left and right, there is a rough friction, friction and pain and discomfort; or the examiner pushes the tibia to one hand On the side, the thumb of the other hand presses behind the edge of the humerus to cause pain.

6, single leg squat test: the patient's single leg weight, gradually squatting to 90 ° -135 ° pain, soft, after a single leg can not stand up.

Imaging examination: X-ray film, arthroscopy, internal iliac vein angiography, CT: Diagnostic value for the diagnosis of patellofemoral disorder and femoral condyle dysplasia to determine the cause and severity of humeral pain.

Diagnosis

Differential diagnosis

Usually, if there is only knee pain, and the pathological examination does not find cartilage fibrosis in the tibial cartilage, it can only be called "tibia femoral pain syndrome". If the cartilage has changed, it is called "the patella cartilage softening." ".

In the knee pain of young people, most of them are of this type; but if it is the knee pain of the elderly, most of them are problems of degenerative arthritis. But the two are still related, because the tibial cartilage has been painful for a long time, and the cartilage is easily worn and becomes degenerative arthritis.

(1) There is pain in the patient's sedentary, squatting, squatting or stepping up and down.

(2) In some cases, the knee joint has a crepitus when it is bent and straightened.

(3) The patient may have undue pressure on the soft tissue due to incorrect patella trajectory, which may affect his proprioception.

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