Infrapatellar pain
Introduction
Introduction One of the signs of instability of the humerus, the tenderness is mostly distributed in the inner edge of the humerus and the medial support zone. When the examiner presses the patient's tibia and performs the flexion and extension test, it can induce subgingival pain. The clinical tenderness is sometimes inconsistent with the painful part of the patient's complaint. Unstable humerus is a common cause of anterior knee pain, a common disease of the patellofemoral joint, and an important cause of patellofemoral softening or patellofemoral joint osteoarthritis. Advances in biomechanics and imaging techniques, as well as the diversity of clinical testing methods, have led to the recognition that the degenerative changes in the patellofemoral joint are caused by the instability of the patellofemoral joint or the instability of the tibia caused by the sacral line. Metatarsal deviation, sacral tilt, high humerus, and humeral subluxation.
Cause
Cause
The cause of patellofemoral joint instability, humeral deviation or subluxation actually includes abnormalities in each structure of the anterior knee region, which are broadly classified into four categories:
1. Abnormalities in the quadriceps and its dilatation: including atrophy or dysplasia of the medial femoral muscle, relaxation, fracture or tear of the medial support ligament, tension of the lateral support ligament and high tibia.
2, knee joint line abnormalities: including Q angle increase, as well as knee, valgus and knee flexion.
3, abnormal shape of the humerus: such as split tibia (patella bipartite), shaped tibia (III, IV type).
4, congenital factors: mainly refers to the development of the femoral condyle, secondary deformation or abnormal shape of the femoral condyle.
The common feature of all these changes is that the patellofemoral joint loses its normal structure, causing an abnormal tensile stress acting on the tibia, or an abnormal trajectory of the tibia, which makes the humerus unstable.
Examine
an examination
Related inspection
Magnetic resonance imaging (MRI) CT examination of the bones and joints of the extremities
Observe the patient's walking or flexion and extension of the knee joint, carefully examine and measure the circumference of the humerus to determine if the bone is displaced or if the thigh muscles are atrophied. Whether there is a fear sign, the 45° axial phase of the knee joint can show the anastomosis of the patellofemoral joint. At the same time, other causes of pain, such as cartilage softening or ligament damage, should be excluded. To understand the limb line and quadriceps angle, also pay attention to the activity of the tibia to understand the soft tissue balance of the medial and lateral tibia. CT or MRI can be done to assist in diagnosis if necessary.
Diagnosis
Differential diagnosis
Differential diagnosis of axillary pain:
1. Tibial pain: In the early stage of the tibia femoral pain syndrome, the knees may experience pain when walking, going up and down the stairs, and standing under the armpits. In severe cases, there may be sudden knees unable to force or even stand unstable during walking.
2, week finger tenderness: week finger tenderness: Common in patellofemoral joint cartilage injury. Articular cartilage damage is very common in sports injuries, but it is difficult to diagnose, especially early diagnosis is almost impossible in routine examinations, so it is often ignored and not treated in time. However, no matter what kind of cartilage damage, it may eventually lead to degeneration and necrosis of chondrocytes and permanent damage, so it has attracted attention in recent years.
3, knee pain: tibia knee pain syndrome is a professional vocabulary that describes the pain in front of or around the humerus. Patellaofemoral Pain Syndrome, also known as anterior knee pain, is caused by abnormal movement of the femur during flexion.
4, post-knee pain: the main diseased tissue that causes pain in the knee, the knee joint (the fossa) pain accounted for 1 / 5 to 1/4 of the incidence of knee pain, can not be ignored.
