Le syndrome de la plica au genou

Abstract

Plicae are synovial folds found mostly in the knee joint which can become symptomatic with overuse and synovial inflammation, especially in the setting of a blunt articular trauma. This pathology is mostly found in a young and active population. The plica syndrome is defined by multiple signs and symptoms, some of those related to the impingement of the plica and others to the inflammation of intra-articular structures. Since the prevalence of this syndrome is low, making a diagnosis can be challenging with only the clinical features. In this regard, musculoskeletal ultrasound and MRI have proven themselves very helpful in the last few years. Initial treatment begins with relative rest and rehabilitation. Intra-articular corticosteroids injection can also be beneficial in some circumstances. When conservative treatment fails after more than 6 months, excision surgery must be considered. Persistence of an impingement between a plica and the medial femoral condyle is linked to multiple complications including femoro-patellar chondropathy, osteochondritis dissecans and early tibio-femoral osteoarthritis. Since most of the patients tend to recover from this pathology, clinicians must keep a high level of suspicion when evaluating at-risk populations.