patellaMD.com
  • Welcome
  • the Problem
  • Evaluation
    • History
    • Physical Examination
    • Xrays
  • PatelloFemoral Anatomy
    • The Patella (Kneecap)
    • The Femoral Groove
    • Ligaments and Tendons
    • Other Factors (Hip, Foot, Tissue Type)
  • Patellar Pressure - Lateral Compression - Anterior Knee Pain or PFS
  • Patellar Instability
    • Lateral Patellar Laxity
  • Chondromalacia and Arthritis
  • Surgery
    • Lateral Release
    • Medial PatelloFemoral Ligament - MPFL
    • Lateral PatelloFemoral Ligament Reconstruction with Quadriceps Tendon Graft
    • Tibial Tubercle Transfer
    • MPFL and LPFL Reconstruction with a Single Tendon Graft
    • Patellofemoral Joint Replacement
    • Surgery and Postop Recovery
  • Failed Surgery
    • Failed Lateral Release
    • Failed MPFL Reconstruction
  • Case Reports
    • MO Severe Arthritis and Instability after Failed Surgery
  • Appointments
  • David Shneider MD
    • Curriculum Vitae
  • Scientific Presentations
  • Patient Comments
HISTORY

A good history should make the physician suspicious of a patellar problem even before examining the patient or the x-rays.  When combined with a careful examination and adequate x-rays, the diagnosis should be fairly easy to make in most patients. 

The most significant symptom with patellar problems is pain.  Pain out of proportion to physical findings is patellar until proven otherwise.  I have found that this statement applies most of the time. 

Pain is typically unrelenting and constant.  Going downstairs or down inclines is difficult.  Sitting with the knee bent for long periods is impossible.  Walking is usually painful but dependable. Running is painful or impossible.  Straightening the knee is very difficult.  Pain is usually localized to the inferior medial patella and anterior medial joint line continuing along the inner side of the knee.  These are pressure symptoms! 

Episodes of buckling or giving way with pivoting or activity are patellar instability symptoms.  Pain can also be a significant symptom with instability but usually it is intermittant not constant.
patellaMD.com
David Shneider MD
830 W. Lake Lansing Rd
East Lansing, MI  48823
517-333-3777
517-203-3956 Fax
doc@patellaMD.com

Update February 28, 2016

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