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         Anterior Knee Pain Syndrome:     more detail
  1. The Inter-Rater Reliability and Diagnostic Accuracy of Patellar Mobility Tests in Patients with Anterior Knee Pain (The Physician and Sportsmedicine) by Brett A. Sweitzer, Chad Cook, et all 2010-10-24

81. BioMed Central | Full Text | Anterior Knee Pain: Symptom or Syndrome?
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82. Knee Pain (Anterior) Referral Guideline
Guideline Updated November 2002 Specialty Orthopedics, Physical Therapy knee pain (anterior) Referral Guideline knee pain localized to the anterior portion of the knee, either retropatellar or peripatellar.
http://www.mamc.amedd.army.mil/Referral/guidelines/ortho_kneeant.htm
Acute Low Back Pain Carpal Tunnel Syndrome de Quervain's Syndrome Ganglions Knee Pain (Anterior) Knee Pain (Traumatic) Mallet Finger Shoulder Dislocation Shoulder Pain (Adult) ... MAMC Intranet or WRMC Internet Referral Guidelines Guideline Updated: November 2002 Specialty: Orthopedics, Physical Therapy
Knee Pain (Anterior) Referral Guideline
Please also see the Knee Clinical Standard
Diagnosis/Definition
  • Knee pain localized to the anterior portion of the knee, either retropatellar or peripatellar. Usually a gradual, non-traumatic onset aggravated with increased activity, running, squatting, stair climbing, or prolonged sitting. Symptoms normally decrease with rest.
Initial Diagnosis and Management
  • History and physical examination. Plain films not required. NSAIDs. Avoidance of aggravating activities; profile for active duty soldiers. Strengthening exercises for quadriceps, stretching exercises for quads, hamstrings, and calf muscle.

83. Orthopaedic Center Of The Rockies - Ask The Doctor
anterior knee pain. The most common knee problem seen in our orthopedic clinicis pain that originates in or around the front part of the knee.
http://www.orthohealth.com/askthedoc/anteriorkneepain.cfm
Anterior Knee Pain
The most common knee problem seen in our orthopedic clinic is pain that originates in or around the front part of the knee. A generic name for this is chondromalacia patella. To be more exact, we refer to it as patello-femoral pain. It is pain that often comes from the patella ( kneecap). Causes
There are many causes of this problem, such as trauma (falling on the bent knee or hitting the knee on the dashboard of a car), wear and tear from overuse, certain bone problems, and even some “silent” fractures. During your evaluation, your doctor will closely examine your knee and may take x-rays to determine the cause of the problem. In the majority of cases, a non-surgical approach will be recommended, because most patello-femoral pain responds favorably to a home exercise program, prescribed physical therapy, or to specific modifications of your workout routine. Chondromalacia Patella
The patella is the small bone in the front of the knee. It glides in a groove in the femur (the thigh bone) as the knee bends and straightens out. Where these two bones contact each other, there is a layer of cartilage that coats the bones. The function of the cartilage is to decrease the friction where the bones are in contact and to allow the patella to glide smoothly and easily in the groove. A common analogy is Teflon coating on a frying pan, which keeps food from sticking. Chondromalacia is a condition where the cartilage becomes damaged. This damaged cartilage may exhibit only some focal softening or may develop cracks and fissures. As further degeneration occurs, the cartilage surface becomes rough and irregular, making the knee “noisy” when you kneel, squat or walk up or down stairs. Chondromalacia may be painful.

84. Chondromalacia:Tendinitis-Anterior Knee Pain : Jumpers Knee
Relief,, Sore Legs, Sore Muscles, ACL anterior Cruciate Ligament , knee pain swelling(macrocap Sleep Disorders, Back pain and Stiffness, Mus, Wrist
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The research was performed on mice. Basically they measured the flexibility that would occur over a 20 minute period by moving the mouse leg back and forth during this time period. Numerous tests were performed at three different frequencies to establish the control. The charts show how the muscle resistance decreases over time. In other words, warming up your muscles moves them to maximum flexibility.

85. Osteomyelitis Causes
Iliotibial Band syndrome, Symptoms Sudden onset of sharp or stinging lateralknee pain pain occurs during knee flexion (late swing phase);
http://www.fpnotebook.com/ORT209.htm
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  • 86. Chondromalacia ,Anterior Knee Pain,Jumper's Knee-Tendinitis-Goode Wraps May Reli
    aol.com/DonMcGhie/acl.html anterior Cruciate, pain bursits.html Bursitis of the KneeCarpal Tunnelhttp Chondral.html Clinical Trials pain Swelling Cumulative
    http://www.200.com/chrond.htm
    Goode Wraps Relieve Pain, Swelling and Stiffness by Relaxing Muscles CHONDROMALACIA, ANTERIOR KNEE PAIN, JUMPER'S KNEE TENDINITIS Click Here for Complete Product Information, Clinical Studies, Testimonials, Online Ordering or Call at 1-888-972-7200, if we are not here leave a message Hockey Soccer Basketball Baseball Volleyball Softball Football Gymnastics Golf Swimming Jogging Running chrondromalacia,chondromalacia Patella, anteriorknee pain,jumpers knee, jumper's knee hurts, tendonitis, knee tendon pain, chrondral defects, orthosis, arthralgia, femoral anterversion, osgood-schlatter, orthopedic, anterior cruciate, anterior tibial syndrom ,trauma,ache, injury, disorder, basketball injury, football injury, baseball injury, martial arts injury, karate The key to Goode Wraps is the rare-earth semi-conductor used in the patented massage cones
    • Goode Wraps are simple to use, just slip one on for chondromalacia and jumper's knee pain With a little care, one Goode Wrap can last for years
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    87. PATELLOFEMORAL PAIN
    Details. · Synonyms Patellar Chondromalacia, Excessive Lateral Pressure Syndromeand simply anterior knee pain. · Very common problem, especially in women.
    http://www.emedx.com/emedx/Patellofemoral Pain Outline.htm
    PATELLOFEMORAL PAIN
    Definition
    A descriptive term used to characterize pain that originates from the anterior aspect of the knee
    Details
    Synonyms: Patellar Chondromalacia Excessive Lateral Pressure Syndrome and simply Anterior Knee Pain
    Very common problem, especially in women.
    The pain associated with this disorder may worsen with descending stairs climbing or deep squating. Sitting with your knees flexed for a long period of time in a car or movie theatre may also aggravate the symptoms.
    Causes
    Weakness of the quadriceps muscle (especially the vastus medialis obliqus or VMO) Softening of the retropatellar cartilage (chondromalacia patella) Patellar malalignment (tilting or lateral tracking) Excessive tightness of the lateral retinaculum Overuse (such as intense running without proper training) Direct trauma (A blow to the anterior aspect of the knee cause a contusion) Diagnosis
    HISTORY
    Complaints of pain in the front of the knee Diffuse pain, not typically localized Pain made worse by descending stairs or prolonged sitting Giving way or grinding may be other complaints
    PHYSICAL EXAM
    Check for effusion (knee swelling) Look for quadriceps atrophy (compare to the opposite side) especially the VMO Check patellar tracking with knee flexion and extension (patellar should stay centered) Palpate for area of maximal tenderness Check for restricted medial patellar motion or excessive lateral patellar motion Check quadriceps flexibility (heel to butt with patient on stomach, compare to other side)

    88. KneeIndia-Orthopaedic Surgeon,Knee Pain, Injuries, Replacement Treatment For Ind
    anterior knee pain. SynoymsChondromalacia patella. Anatomical cartilage.This leads to anterior knee pain. This is a very common symptom.
    http://www.kneeindia.com/anterior.html
    KNEEINDIA.COM
    DR.A.K.VENKATACHALAM MS Orth , DNB Orth , FRCS , MCh Orth

    ACL Injury
    Anterior Knee Pain Arthritis Articular Cartilage Injury
    Baker's Cysts
    Chondromalacia patella ... Subluxation Anterior Knee Pain Synoyms-Chondromalacia patella Anatomical background -The knee joint is formed by the union of three bones, namely the femur (thigh bone), the tibia (leg bone) and the Patella (knee cap). The Patella is a floating bone in the tendon of the powerful thigh muscle. It sits in a pulley like groove in the lower end of the femur. The tibia and femur join with each other at the knee joint. The inner surface of all these bones is lined with smooth articular cartilage. Overuse, abnormal stresses, injuries or malalignment can lead to a softening of this cartilage. This leads to anterior knee pain. This is a very common symptom. It results from increased friction due to roughness at the contacting surfaces of the kneecap and the femur. Symptoms
    • Pain at the front of the knee while descending or ascending stairs or rising from a squatting position.The patient feels a grating sensation inside the knee or complains that the fluid inside the knee has dried out.

    89. Knee India-Source Of Information On Knee Health And Knee Disorders For Indians G
    Ilitoibial band syndrome. Symptoms A snapping sensation over the knee whenever theknee bends. pain over the tendon which is worse with activity and better with
    http://www.kneeindia.com/ilitibial.html
    KNEEINDIA.COM
    DR.A.K.VENKATACHALAM MS Orth , DNB Orth , FRCS , MCh Orth
    ACL Injury Anterior Knee Pain Arthritis Articular Cartilage Injury ... Housemaid Iliotibial band syndrome
    Infectious Arthritis
    Lateral collateral ligament injury
    Medial collateral ligament injury

    Meniscal injuries
    ... Subluxation Ilitoibial band syndrome The ilitoibial band is a long band of tendon extending from the ilium to the knee. It helps to bind the thigh muscle down. It can become inflamed in people who overuse it, say in runners and cyclists. Symptoms
    • A snapping sensation over the knee whenever the knee bends. Pain over the tendon which is worse with activity and better with rest.

    90. Anterior Knee Pain
    The main causes of of anterior knee pain have been determined to patient has a familyhistory of knee injuries, where pain is located, and if the pain set in
    http://whs.wsd.wednet.edu/sportsmed/Fenton
    i
    Anterior Knee Pain
    The Challenge of Patellofemoral Syndrome
    Volume 47 Number 1(January, 1993)
    Mack T. Ruffin IV, M.D., M.P.H., and Robert B. Kiningham, M.D., M.A.
    Abstract
    Anterior knee pain is a very common impairment among runners. This pain in the back of the knee is caused by stresses of the patellofemoral joint. Because the patella is held in place only by ligaments and tendons, any abnormalities in these may disturb the patellofemoral movment and result in anterior knee pain. Since articular cartilage has no nerve endings, it cannot be considered as a primary source of knee pain.
    The main causes of of anterior knee pain have been determined to be wasting of medial quadriceps, increased Q angle, patellar position, femoral rotation, femoral neck rotation, variation in patellar shape, genu valgum, tibial torsion, pateller instability, and medial facet overuse.
    As in all injuries, the history of the patient can help in determining the injury. Whether the patient has a family history of knee injuries, where the pain is located, and if the pain set in immediatly or after the injury occured, all play into the final diagnosis. In cases of Patellofemoral Syndrome, the pain is usually around the whole knee and not in a specific spot. The pain worsens after acitivities such as climbing stairs or running uphill. The feeling is not one of acute pain, but more a feeling of "giving way."
    There are four phases of treatment for Patellofemoral Syndrome. These phases are: the acute, subacute, chronic, and maintanence phases. The acute phase is used to minimize the pain, keep swelling down, and prevent the break-down of muscles. Treatments usually include an ice massage, use of inflammatory drugs, and restricted activites. Rehabilitation starts with stretching the quadriceps, hip adductors and hamstrings, followed by exercises. This phase lasts two to three weeks.

    91. INTRODUCTION & DEFINITION
    any one of 'patellofemoral pain syndrome,' 'chondromalacia patellae','recalcitrantanterior knee pain', 'patellofemoral stress syndrome', 'femoropatellar pain
    http://www.ucalgary.ca/~kneepain/Intro.htm
    Anterior Knee Pain (AKP) is a nonspecific diagnosis that refers to pain expressed in the anterior region of the knee. It is a common clinical problem seen in all age groups and presented to general practice, sport medicine, orthopaedic and emergency department settings. Previous studies by our research group have confirmed that a paucity of consensus exists in the following areas definition classification , assessment, diagnosis and management of anterior knee pain. This lack of consensus and the ambiguity of the term 'anterior knee pain' creates confusion and frustration for both the clinician and the patient. Anterior Knee Pain has been referred to as any one of ' patellofemoral pain syndrome chondromalacia patellae recalcitrant anterior knee pain patellofemoral stress syndrome femoropatellar pain syndrome patellofemoral arthralgia ' or ' patellalgia '. Without consensus on the definition, etiology and/or management of anterior knee pain, a symptom such as pain in the anterior region of the knee becomes accepted as a diagnosis. The treatment process then results in a subjective focus on the symptoms rather than individualizing treatment based upon causative and/or etiologic factors. The use of consensus statements in the assessment and management of knee disorders may assist in alleviating the confusion for patients and physicians, and may result in more efficient use of health care dollars. The AKP research group is undergoing a multi-phased approach to developing consensus statements in the areas of definition, assessment, diagnosis and management. Consensus that is based upon current scientific literature coupled with 'expert' opinion and review assists in providing a strong foundation for developing clinical guidelines.

    92. Knee Pain (Anterior) Referral Guideline
    knee pain (anterior) Referral Guideline. Diagnosis/Definition. knee pain localizedto the anterior portion of the knee, either retropatellar or peripatellar.
    http://www.mamc.amedd.army.mil/referral/guidelines/ortho_kneeant.htm
    Acute Low Back Pain Carpal Tunnel Syndrome de Quervain's Syndrome Ganglions Knee Pain (Anterior) Knee Pain (Traumatic) Mallet Finger Shoulder Dislocation Shoulder Pain (Adult) ... MAMC Intranet or WRMC Internet Referral Guidelines Guideline Updated: November 2002 Specialty: Orthopedics, Physical Therapy
    Knee Pain (Anterior) Referral Guideline
    Please also see the Knee Clinical Standard
    Diagnosis/Definition
    • Knee pain localized to the anterior portion of the knee, either retropatellar or peripatellar. Usually a gradual, non-traumatic onset aggravated with increased activity, running, squatting, stair climbing, or prolonged sitting. Symptoms normally decrease with rest.
    Initial Diagnosis and Management
    • History and physical examination. Plain films not required. NSAIDs. Avoidance of aggravating activities; profile for active duty soldiers. Strengthening exercises for quadriceps, stretching exercises for quads, hamstrings, and calf muscle.

    93. Knee - Chondromalacia Patella, Anterior Knee Pain
    as softening of the cartilage of your knee cap or anterior knee pain . with restand the use of pain medication after a growth spurt where the knee must carry
    http://www.jointhealing.com/pages/knee/chondromalacia.html
    JointHealing.Com what hurts? ankle arthritis back foot knee shoulder specific problems: ACL tear Knee Arthritis MCL tear/sprain Knee tendonitis Meniscus tear Impingement syndrome Rotator Cuff Tear Shoulder dislocation Shoulder arthritis Low back pain Herniated disk Sciatica Ankle sprain Foot pain products: Glucosamine Knee Braces Rehabilitation kits Orthotics/Shoe inserts Cryotherapy units Back products Ankle products Shoulder products Home Knee
    Anatomy

    Symptoms
    ... Discussion Groups
    Knee Problem: Chondromalacia Patella
    This disease is also known as softening of the cartilage of your knee cap or "anterior knee pain". This is a big medical word for a condition where the shiny cartilage surface of your patella (knee cap) is softened due to many factors including abnormal pressure across the joint surface or hormonal changes in your body. This pain is usually located over the front of your knee and is described as a deep aching pain. It is sometimes associated with swelling and is usually worse when your knee is bent for long periods of time such sitting in a car or bus. The pain is also worse with such activities as squatting, kneeling or stair climbing (either up or down stairs). The pain is sometimes improved with rest and the use of pain medication. It is sometimes associated with mild or moderate swelling of the knee and some people report a grinding feeling in their kneecap. It is more common in younger females especially after a growth spurt where the knee must carry more weight.

    94. Chondromalacia Patella (knee Pain In Sports) Information
    with walking, running, or jumping; anterior pain when descending feeling of grating)as knee actively flexes pain with contraction of quadriceps while patella
    http://veggie.org/run/chondromalacia/
    A Common Cause of Knee Pain in Sports
    Chondromalacia Patella
    by Kristen Xan Walker for the University of Oregon
    Click the above image for the anatomy of the Knee
  • What is Chondromalacia Patella?
    What is Chondromalacia?
    Definition: Chondromalacia is a softening or wearing away and cracking of the articular cartilage under the patella, resulting in pain and inflammation.
    Chondromalacia Patella is often used by physicians as a catch-all term to describe anterior knee pain that results from patellar malalignment. The strict definition, however, is simply the degeneration of the cartilage on the posterior aspect of the kneecap.
    The articular cartilage on the posterior aspect of the patella comes in constant contact with the articular surfaces of the femur during normal knee motion. (Fig. 1)
  • 95. The Steadman-Hawkins Clinic
    are retropatellar pain, peripatellar pain, anterior knee pain, and runner's knee disordersthat cause pain around the tendonitis (jumper's knee), which affects
    http://www.steadman-hawkins.com/pate/overview.asp
    Patellofemoral pain syndrome (PFPS) is a common knee disorder, which often affects the senior athlete and those involved in running and jumping sports. Overuse, a change in activity, and an altered metabolic status are frequently responsible for the development of PFPS. Structural alignment and muscular weakness or imbalance may cause the patella (kneecap) to track improperly on the femur (thigh bone) during movement, leading to pain around the kneecap.
    Other terms for patellofemoral pain are: retropatellar pain, peripatellar pain, anterior knee pain, and runner's knee.
    Different disorders that cause pain around the kneecap include:
    • infrapatellar tendonitis (jumper's knee), which affects the tendon just below the kneecap
    • chondromalacia patella, which involves damage to the cartilage surface of the patella
    • quadriceps tendonitis, which affects the tendon attachment above the patella
    • plica syndrome

    96. Keep Kids Healthy Common Adolescent Problems: Knee Pain
    Ligament injuries can cause pain, bruising and swelling and The knee may also be immobilizedfor up to most common injury is to the anterior cruciate ligament
    http://www.keepkidshealthy.com/adolescent/adolescentproblems/kneepain.html

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    Recommend Us tell a friend about us or email this page to a friend Main Adolescent Adolescent Problems Knee Pain The knee is made up of bones, cartilage (or menisci) that lie between the knee and the bones of the lower leg, ligaments that run along the inside and outside part of the knee (medial and lateral collateral ligaments ), and ligaments that cross the inside of the knee (anterior (ACL) and posterior (PCL) cruciate ligaments ). Injury to any of these structures can cause knee pain. It is very common for children to complain of knee pain, especially adolescents that are active in sports. If your child has knee pain that is restricting his activities, if he is unable to bear weight on the leg, or if his knee is red or swollen, then you should see your doctor for an evaluation. Some common causes of knee pain in children include:
    • Parapatellar knee pain syndrome or chondromalacia patellae: children with this common condition usually have vague pain in both knees around the knee cap or patella. It is not known what causes the pain and x-rays and other testing will be normal. The pain is made worse by certain activities, such as running, jumping, doing knee bends, sitting for a long time, or climbing stairs and improves after a period of rest. Treatment consists of rest from any activity that regularly makes the pain worse, avoiding knee bend exercises (especially weight machines), and using an anti-inflammatory medicine such as ibuprofen. You can also do strengthening exercises, such as isometric quadriceps exercises (see below) and/or flexibility exercises.

    97. New Page 0
    It is characterized by complaints of vague pain around or underneath though the patientmay feel that the knee collapses due to the anterior knee pain.
    http://www.bol.ucla.edu/~ofattal/kneepain.htm
    KNEE PAIN Index Anterior knee pain. In immature athletes, frequent knee extension can lead to traction apophyseal injury with local tenderness at secondary growth centers of the distal patellar pole (Sinding-Larsen-Johansson disease) and the tibial tubercle (Osgood-Schlatter disease). Postactivity ice massage to these painful areas can be of great benefit. Patellofemoral pain syndrome (PPS) can affect an athlete of any age. It is characterized by complaints of vague pain around or underneath the patella that worsens with prolonged running, standing, or sitting in a chair. Swelling and frank instability are uncommon, though the patient may feel that the knee "collapses" due to the anterior knee pain. The exact mechanism of PPS is uncertain, but many believe that malalignment of the patella about the distal femur is the main problem. Weak or uncoordinated quadriceps muscles, especially the vastus medialis oblique (VMO), can lead to abnormal lateral movement of the kneecap or excessive contact of the patellar undersurface with the femur, both leading to pain. Start the exam by focusing on the knee alignment in stance. Pronounced valgus knee alignment and underdeveloped quadriceps (especially the VMO) are particular risk factors for PPS. On manual examination, there is significant pain on patellar compression or excessive lateral translation of the patella. There should be no sign of ligament instability or meniscus injury.

    98. Knee Exam
    patella is a wastebasket term for anterior knee pain without breaking the source ofpain in an unanesthetized knee. Deep Joint pain pain deep inside the joint
    http://www.sportsdoc.umn.edu/Clinical_Folder/Knee_Folder/Knee_Exam/tenderness ma
    Rehab Protocols
    Interactive Knee Exam

    Viscosupplementation
    Finding, the exact location of a patient's pain (when possible) and correlating it to potential abnormalities or specific anatomic structures is an essential part of the physical exam. We recommend that a standard systematic exam be followed in every patient and that the area of maximal tenderness be palpated last to prevent the patient from guarding due to pain during the exam. Joint Line Pain:
    Joint line pain can be indicative of a tear of the lining of the joint (the capsule), a meniscus tear, or may indicate abnormalities with the bone or cartilage at the joint line (chondromalacia, arthritis, osteochondritis dissecans, etc). In the evaluation of joint line pain, we perform this concurrent with either a varus or valgus stress test . While we are applying a stress across the joint, we place our fingers directly over the joint line to assess for joint line pain, a clunk (which may indicate a peripheral meniscal tear ), or intraarticular crepitation (which may indicate cartilage damage or a

    99. Patellafemoral Pain Syndrome: An Associated Disorder Or...
    it is suggested that remaining patients with a clinical presentation of anteriorknee pain could be diagnosed with patellofemoral pain syndrome (PFPS).
    http://www.chiroweb.com/archives/18/14/12.html
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    Patellafemoral Pain Syndrome: An Associated Disorder or Medical Problem?
    by Joseph Kurnik,DC There is no clear consensus in the literature concerning the terminology, aetiology and treatment for pain in the anterior part of the knee. The term 'anterior knee pain' is suggested to encompass all pain-related problems. By excluding anterior knee pain due to intra-articular pathology, peripatellar tendinitis or bursitis, plica syndromes, Sinding Larsen's disease, Osgood Schlatter's disease, neuromas and other rarely occurring pathologies, it is suggested that remaining patients with a clinical presentation of anterior knee pain could be diagnosed with patellofemoral pain syndrome (PFPS). Three major contributing factors of PFPS are discussed: (1) malalignment of the lower extremity and/or the patella: (2) muscular imbalance of the lower extremity: and (3) overactivity. The above excerpt was the opening statement of a review article in Sports Medicine

    100. Orthoseek | Orthopedic Topics | Chondromalacia Patellae
    Orthoseek article, with recommended exercises and information on prevention, treatment and the developmen Category Health Conditions and Diseases Chondromalacia...... of the cartilage. A more appropriate diagnosis would be Anteriorknee pain syndrome or Patellofemoral stress syndrome . In fact
    http://www.orthoseek.com/articles/chondromp.html
    Chondromalacia Patellae
    What is Chondromalacia patellae? Chondromalacia literally means "softening of the cartilage", and Patellae means "the knee-cap". So Chondromalacia patellae means "softening of the articular cartilage of the knee-cap." The articular cartilage is the cartilage lining under the knee-cap that articulates with the knee joint. Under normal circumstances, it is smooth and shiny, so that it glides smoothly along the articular groove of the femur as the knee bends. When it "softens", it may break down, causing irregularities along the undersurface of the patella. What causes Chondromalacia patellae? Chondromalacia patellae occurs in two distinct age-groups:
    • It can happen in the older age-group (in the 40’s and beyond) when the articular cartilage breaks down as part of the wear-and-tear process that occurs with the rest of the body. The patella cartilage is one of the earliest places where cartilage breakdown occurs, and is slowly progressive, leading to degenerative arthritis (osteoarthritis) in the knee joint.
    • It can occur frequently in teenagers (especially girls) when the articular cartilage "softens" in response to excessive and uneven pressure on the cartilage, due to structural changes in the legs with rapid growth, and muscle imbalance around the knee. During periods of rapid growth, especially in girls, any knee valgus (knock-knees) is accentuated, thereby increasing the

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