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.
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.
