PF Pain in the Skeletally Immature Patient: Diagnosis and Management

Abstract

Anterior patellofemoral knee pain is a common complaint in the child and young adolescent population. Following proper physical exam, clinical history, and diagnostic imaging studies, discrete diagnoses for anterior knee pain can often be made. These diagnoses include Osgood-Schlatter’s disease, tibial tubercle fracture, Sinding-Larsen-Johansson syndrome, patellar sleeve fracture, bipartite patella, trochlear or patellar juvenile osteochondritis dissecans, Hoffa’s fat pad impingement, and plica syndrome. However, for many patients, a discrete diagnosis cannot be made, and these cases fall into the diagnostic categories of anterior knee pain in adolescents and patellofemoral pain syndrome – both of which had historically been referred to as chondromalacia. This chapter will delineate the ways to identify discrete diagnoses for anterior PF knee pain and separate them from these broader diagnostic categories. It will also discuss treatment and rehabilitation for the common causes of patellofemoral pain. Representative cases are presented.