Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with chronic, intermittent anterior right knee pain, localized medial to the patella. Symptoms are exacerbated by repetitive flexion/extension activities, prolonged sitting ("theater sign"), and stair climbing. Reports occasional clicking, snapping, or catching sensation during knee motion. No history of acute trauma or locking.
Clinical Examination Findings
Right knee inspection reveals no significant effusion or erythema. Palpation demonstrates localized tenderness along the medial patellar facet. Plica "stutter" test is positive with palpable snapping during active extension from 90 to 0 degrees. Patellar tracking is within normal limits; no ligamentous laxity (Lachman, Varus/Valgus stress tests negative). Meniscal provocation tests (McMurray) are negative.
Treatment Protocol
Conservative management initiated: Activity modification (avoidance of aggravating repetitive flexion), NSAIDs for inflammation, and targeted physical therapy focusing on quadriceps strengthening and hamstring flexibility. Consider corticosteroid injection into the medial plica if symptoms persist. Surgical consultation for arthroscopic plica excision if refractory to 3-6 months of conservative care.