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Patellofemoral Pain Syndrome (aka "Runner's Knee")
Overview
Patellofemoral pain syndrome (aka "runner's knee") is a common cause of pain around or behind the patella due to overuse/overload.
It most commonly occurs in young women (anywhere from 10 to 20 years-old).
It is aggravated by weight-bearing on a flexed knee (squatting position).
Patellofemoral pain syndrome is a diagnosis of exclusion that is made clinically (no imaging required).
Risk Factors
Risk factors include malalignment, overload, and direct trauma.
Notable causes of overload are a runner's total mileage or sudden increase in mileage. As well, a high BMI in an active individual can cause overload and induce patellofemoral pain syndrome.
Presentation
The anterior knee pain is typically achy in quality and localizes to beneath or around the patella. It can develop abruptly or insidiously (note that it can occur secondary to trauma). It may be unilateral or bilateral and there are a variety of aggravating activities, such as squatting, climbing/descending stairs, running, prolonged sitting.
Patients may describe a buckling knee or a catching sensation. In these patients it is especially important to rule-out patellar displacement (dislocation or subluxation), knee ligament injuries, patellofemoral osteoarthritis, or intraarticular pathology.
Management
Management involves activity modification, short-term use of NSAIDs, and icing the knee.