Anterior Knee Pain in Adolescents: Expanding Your Differential

Abstract

Anterior knee pain is among the most common pediatric musculoskeletal complaints. Commonly clinicians attribute this complaint to overuse, inequalities of flexibility and strength, and unique stresses placed on the patellofemoral joint during skeletal growth. Frequent diagnoses include patellofemoral pain syndrome, quadriceps or patella tendinopathy, tibial tubercle apophysitis, pes anserine bursitis, and fat pad impingement. It is important to consider there are less common causes of pediatric anterior knee pain. These may require further workup and specialist referral. Understanding of history taking and physical examination findings is key to forming an accurate working differential diagnoses list and directing timely management.