Diagnosis of patellofemoral pain syndrome

Diagnosis of patellofemoral pain syndrome is clinical, based on history and examination. Risk factors for patellofemoral pain syndrome include female gender, obesity, and joint laxity.

The pain has an insidious onset and is generally felt anteriorly in the knee but may be felt behind the patella. The knee may appear to be normal and effusion is uncommon. Tenderness may be felt under the borders of the patella. Direct compression or medial and lateral movement of the patella may reproduce the pain.

Suggested criteria for diagnosing patellofemoral pain syndrome include all of the followingWallis, 2021:

• presence of retropatellar or peripatellar pain
• reproduction or aggravation of the pain when squatting (one-legged or 2-legged), climbing stairs, prolonged sitting, or other functional activities that load the knee when in a flexed position
• exclusion of other conditions causing anterior knee pain, including tibiofemoral pathologies.

Assess for biomechanical abnormalities that may be associated with patellofemoral pain syndrome, which include:

• excessive pronation of the subtalar joint
• weak quadriceps and tight hamstrings
• tight lateral patellar retinaculum
• laterally placed tibial tuberosity.