Diagnosis and treatment of anterior knee pain

Sanchis-Alfonso, Vicente; McConnell, Jenny; Monllau, Joan Carles; Fulkerson, John P.

doi:10.1136/jisakos-2015-000033

Cited by 29 publications

(21 citation statements)

References 85 publications

(99 reference statements)

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“…Gray-scale and color Doppler ultrasonography of the knee were performed using Aplio 400, Toshiba ultrasound scanner, with a high-resolution, multifrequency linear transducer (7)(8)(9)(10)(11)(12). Patients were positioned in a supine position with the knee comfortably flexed (30-45°) by placing a pillow under the knee.…”

Section: Ultrasonography and Color Doppler Technique And Analysismentioning

confidence: 99%

“…The patient's clinical history and physical examination are of paramount importance in diagnosing the cause of AKP. The physical examination is complemented by imaging examinations, and the combination should yield a precise diagnosis that will be the cornerstone in developing an appropriate therapeutic program [7]. Imaging workup is important to evaluate the extent of the bone and soft tissue abnormality and guide therapeutic intervention if needed [8,9].…”

Section: Introductionmentioning

confidence: 99%

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Diagnostic accuracy of ultrasonography in the assessment of anterior knee pain

et al. 2020

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Background Anterior knee pain (AKP) is a problematic complaint, considered to be the most frequent cause of orthopedic consultancy for knee problems. This study aimed to highlight diagnostic accuracy of ultrasonography as a fast imaging technique in assessment of patients with AKP. Methods and results A prospective study was conducted on 143 patients with clinically confirmed AKP. All patients underwent ultrasonography and MRI examinations of the knee. The diagnostic accuracy of ultrasonography compared to MRI for evaluating different findings of possible causes of AKP were analyzed using receiver operating characteristic (ROC) curve and judged by area under curve (AUC). A total of 155 knees were included in the study; 26 knees showed no abnormalities, 19 knees showed positive MRI only, and 110 knees showed positive ultrasonography and MRI. Ultrasonography and MRI reported 11 different findings of possible causes of AKP or related to it. Joint effusion was the most common finding (38%) followed by trochlear cartilage defect (20.6%) and superficial infrapatellar subcutaneous edema (20%). The overall accuracy of ultrasonography was 85.3% sensitivity and 100% specificity. The ultrasonography provided the highest sensitivity (100%) in detecting bipartite patella, followed by 91.5% for joint effusion, and 87.5% for quadriceps tendinopathy. The ROC curve analysis of overall accuracy of ultrasonography showed an AUC of 0.93. The overall Kappa agreement between ultrasonography and MRI was good (k = 0.66). Conclusion Ultrasonography can be used to make a swift screening and assessment of painful anterior knee and as an alternative to MRI when it is unavailable or contraindicated.

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Section: Ultrasonography and Color Doppler Technique And Analysismentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Diagnostic accuracy of ultrasonography in the assessment of anterior knee pain

et al. 2020

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“…She had great difficulties in driving her car because of the pain caused upon engaging the clutch, going downstairs, wearing high heels, and sitting with the bent knee for a long period of time (“movie sign”). The psychological evaluation that we routinely perform on our patients with AKP did not indicate anxiety, depression, kinesiophobia, or catastrophizing [ 7 ]. The physical therapy program (patellar taping, muscle training, and flexibility exercises) performed in our institution [ 7 ] was unsuccessful in improving her symptoms.…”

Section: Case Reportmentioning

confidence: 99%

“…The psychological evaluation that we routinely perform on our patients with AKP did not indicate anxiety, depression, kinesiophobia, or catastrophizing [ 7 ]. The physical therapy program (patellar taping, muscle training, and flexibility exercises) performed in our institution [ 7 ] was unsuccessful in improving her symptoms. This pain forced her to abandon the sports activities but she kept going to the gym.…”

Section: Case Reportmentioning

confidence: 99%

Cam Femoroacetabular Impingement as a Possible Explanation of Recalcitrant Anterior Knee Pain

Sanchis-Alfonso

Tey

Monllau

2016

Case Reports in Orthopedics

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We present a case of a patient with chronic anterior knee pain (AKP) recalcitrant to conservative treatment who returned to our office for severe hip pain secondary to Cam femoroacetabular impingement (Cam FAI) at 10 months after the onset of knee pain. This case highlights the fact that the main problem is not in the patella but in the hip in some patients with AKP. We hypothesize that there is an external femoral rotation in order to avoid the impingement and therefore the hip pain in patients with Cam FAI. This functional femoral rotation could provoke a patellofemoral imbalance that may be, in theory, responsible for patellofemoral pain in this particular patient. In our case, Cam FAI resolution was related to the resolution of AKP.

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“…3 Anterior knee pain, also called patellofemoral pain (PFP), 5 is a frequent cause for medical care. 4 Short and long distance recreational runners report mainly knee injuries, 6 with 50% of them resulting from excessive use. 3 In addition, these lesions may be associated with risk factors, such as body mass index (BMI) 7 and advanced age.…”

Section: Introductionmentioning

confidence: 99%

Relação entre sintomatologia no joelho e as características biológicas em corredores recreacionais

Ribeiro

Berni

2020

Rev Bras Ortop (Sao Paulo)

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Resumo Objetivo O principal objetivo do presente estudo foi comparar a percepção subjetiva de dor e sintomas de dor anterior no joelho com as diferentes classificações de índice de massa corporal (IMC). O objetivo secundário foi verificar a associação entre as variáveis biológica e antropométrica com os resultados apresentados pelos sujeitos nos questionários subjetivos. Métodos Foram recrutados 126 corredores recreacionais de ambos os gêneros, com idades entre 20 e 59 anos. Foram coletados dados referentes à variável biológica idade, e as variáveis antropométricas peso e altura, além da escala visual analógica (EVA) e os questionários Lysholm e Kujala. As informações foram obtidas por meio de plataforma digital, disponibilizado em um único link, para que fossem respondidos através de dispositivos eletrônicos pelos próprios voluntários. A normalidade foi verificada por meio do teste Shapiro-Wilk. Foi utilizado o teste-T e o teste de Wilcoxon para comparação das médias. A associação entre as variáveis foi determinada pela correlação linear de Pearson. Resultados Houve diferença significativa entre a estatura do grupo sobrepeso e o grupo obesidade grau 1 (p = 0,029), e o peso do grupo peso normal para os grupos sobrepeso e obesidade grau 1 (p < 0,001), e entre as médias do IMC (p < 0,05). Foi observada correlação significativa não clara entre o IMC e os questionários específicos e a escala subjetiva (p < 0.05). Conclusão Os corredores recreacionais que possuem IMC acima dos valores de normalidade estão mais predispostos a apresentar dor no joelho do que aqueles com IMC normal.

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Diagnosis and treatment of anterior knee pain

Cited by 29 publications

References 85 publications

Diagnostic accuracy of ultrasonography in the assessment of anterior knee pain

Diagnostic accuracy of ultrasonography in the assessment of anterior knee pain

Cam Femoroacetabular Impingement as a Possible Explanation of Recalcitrant Anterior Knee Pain

Relação entre sintomatologia no joelho e as características biológicas em corredores recreacionais

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