Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with chronic, activity-related anterior-medial right knee pain. Symptoms exacerbated by repetitive flexion/extension, prolonged sitting ("theater sign"), and stair climbing. Reports intermittent clicking, snapping, or catching sensation along the medial femoral condyle. No history of acute trauma or locking. Pain is localized to the medial patellofemoral joint line.
Clinical Examination Findings
Right knee exam reveals localized tenderness to palpation over the medial femoral condyle and the medial patellar facet. Plica snapping test is positive with reproducible audible/palpable click during passive flexion/extension. Patellar grind test (Clarkeโs sign) is positive for retropatellar crepitus. No joint line tenderness, no ligamentous laxity (Lachman/Varus/Valgus stable), and no effusion noted.
Treatment Protocol
Conservative management initiated: activity modification, avoidance of aggravating repetitive flexion, and physical therapy focusing on quadriceps strengthening and hamstring flexibility. Prescribed NSAIDs for inflammation control. Consider corticosteroid injection into the medial plica if refractory to conservative measures. Surgical consultation for arthroscopic plica resection if symptoms persist >6 months.