EpistemisPrevious gonalgia
Specialty: Musculoskeletal.
Why it occurs
- Patellofemoral pain syndrome (malalignment of the patella with overload of the cartilage)
- Chondromalacia patella (softening and cracking of the patellar cartilage)
- Patellar tendinopathy (inflammation of the patellar tendon, common in jumping athletes)
- Quadriceps tendinopathy (proximal insertion of the patella)
- Infrapatellar or prepatellar bursitis
- Hoffa fat pad syndrome (hoffitis or infrapatellar fat impingement)
Initial workup
Knee radiographs (AP, lateral flexion and axial projections of the patella at 30° and 45° to evaluate patellar scale) | Knee MRI (assesses the degree of patellar chondropathy and bone edema in Hoffa's fat or tendon) | Dynamic ultrasound of the patellar and quadriceps tendon.
red flags
Previous knee pain that is associated with progressive lameness with severe amyotrophy of the quadriceps muscle, abundant recurrent joint effusion and exquisite bone pain on percussion of the patella at rest (rule out avascular necrosis of the patella or patellar bone tumor).
Standard management
- Etoricoxib — 60 mg once a day orally for 5-7 days, indicated in the phases of synovitis or acute tendinitis
- Topical application of piroxicam gel 0.5% every 12 hours
- Glucosamine sulfate — 1500 mg once daily orally, for long-term cartilage protection
- Peritendinous platelet-rich plasma (PRP) infiltration in refractory patellar tendinopathies.
Educational guidance for study. It is NOT a prescription recommendation. The actual choice depends on the cause, the patient, and current guidelines.
- Area
- Musculoskeletal
- Listed causes
- 6
- Treatment options
- 4