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Background: Anterior knee pain (AKP) is the commonest cause of knee complaints. It represented about 25% of all adult knee problems and its non-specific complaint has multiple causes and risk factors. Objective: This study aims to evaluate the role of magnetic resonance imaging (MRI) in diagnosing different diseases that cause pain in the front of the knee. Patients and methods: A cross sectional study of forty eight patients with history of anterior knee pain. All patients were referred from the outpatient clinic of orthopedic surgery, Zagazig University Hospitals. This work was performed at the MRI unit of Radiodiagnosis Department, Zagazig University Hospitals. Results: The mean age of the studied group was 37.35±13.78 years. Visual Analog Scale (VAS) was (4.62±1.16) with more than half (56.2%) of cases having right sided pain. Most presenting symptoms was isolated anterior knee pain (62.5%). The frequency distribution of all MRI findings in all patients showed that 58.3% of the studied group had patellar tilt, 33.3% had patellar chondromalacia or patellofemoral instability, and 20.8% of cases had patellofemoral osteoarthritis. Conclusion: MRI is proven to be the technique of choice in differentiation between various knee pathologies that cause AKP in different age groups due to its safety. Also, MRI has the ability to detect the different grades of some knee pathologies as trochlear dysplasia, chondromalacia patella or factors that may predispose to them.

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