Medial patellar plica syndrome

Medial patellar plica syndrome is one of the conditions that can be associated with the presence of synovial plicae of the knee (in this instance a medial plica). It can be a common source of anterior knee pain.

While it can affect those of any age, it typically involves the young patients involved in repetitive athletic activity.

Patients may present with pain over the anteromedial aspect of the knees (mostly above the joint line 8) and this may be accompanied by episodes of crepitation, catching, and pseudo-locking sensations. 

Knee plicae are synovial invaginations which are thought to be remnants of embryological development. Plicae ≥ 1 mm may be present in over 70% of individuals and are mostly asymptomatic 8-9. Under certain circumstances they carry the potential to become inflamed and symptomatic. There can be fibrosis of a plica rendering it inflexible 8.

Plain film

Plicae are occult on plain film.

MRI

Useful at identifying the presence of a plica and if it is thickened (typically appears like a shelf like band). Signal characteristics of plicae are:

  • T1: low signal
  • T2/PD: low signal

In symptomatic patients thickening of the medial plica and associated chondral defect of the medial patella facet can be seen.

Management options range from the conservative end of rest - physiotherapy to corticosteroid injections to arthroscopic surgery.

Knee pathology

The knee is a complex synovial joint that can be affected by a range of pathologies:

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Article information

rID: 36533
Section: Syndromes
Tag: cases
Synonyms or Alternate Spellings:
  • Medial plica syndrome

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