Chondromalacia patella – What are the Signs and symptoms, relevant dDx, Sequelae, work up and Treatment options?

Chondromalacia patella is a softening of the articular cartilage of the patella, usually caused by improper tracking of the kneecap (patella) as it slides over the bone of the thigh (femur). This misalignment leads to degeneration of the cartilage underneath the kneecap and results in localized knee pain

Sn. & Sx.:

• Deep, aching anterior knee pain
• Knee pain < going up and down stairs
• Pain with resisted extension
• Sensation of instability
• Tenderness on palpation

dDx:

• Meniscus tear
• Patellar tendonitis
• Patellofemoral osteoarthritis
• Cruciate ligament injury

Sequelae:

• Impaired social and occupational functioning 

Work up:

• Orthopedic testing (Clark’s sign Patellar-femoral grind test)
• Imaging (X-ray)

Tx:

• Analgesics (NSAIDs)
• Physiotherapy to strengthen supporting muscles (quadriceps, hamstrings, hip abductors)

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This post was written by Omar Rifai