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Dr. Allan Mishra | Knee Pain Diagnosis



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 Definition A painful plica is caused by inflammation of a band of tissue just to the inside part of the kneecap.

A plica is a band of dense scar-like tissue that occurs normally in many people. It is left over tissue from when the knee was developing prior to birth. Most of the time, a plica does not cause pain.
Causes A plica can become painful after a direct blow to the front of the knee or from overuse of the knee. Increased training for long distance running or cycling events without proper stretching is one common cause of a painful plica.
Diagnosis Patients with painful plicas complain of pain in the front or just to the inner side of their knees. Deep bending of the knee worsens the pain or may cause the band to snap across the knee. Sitting in a car or movie theatre may produce discomfort similar to the patellofemoral pain syndrome. This area is also tender to the touch and a thickened cord-like structure can usually be felt. Localized swelling may accompany the tenderness. X-rays are taken to rule out bony causes of the pain. Rarely, an MRI will be employed to either confirm the diagnosis or rule out a meniscus tear on the inner part of the knee
Treatment The overwhelming majority of painful plicas can be treated non-operatively. The treatment is directed along a three phase protocol: control of pain and inflammation, restoration of function and return to sports. Flexibility of the muscles around the knee and tissues around the kneecap are emphasized.

Rarely, arthroscopic surgery is needed to remove the inflammed and scarred plica to eliminate the pain.

Arthroscopic Picture of a Plica

Maintain strong and flexible muscles around the knee, especially quadriceps stretching
Use pads to avoid direct blows to the front of the knee