Presentation
Knee pain, difficulty climbing stairs and intermittent instability.
Patient Data
Edema and fluid are seen in the fat interposed between the lateral aspect of the patellar tendon and the lateral trochlear ridge of the lateral femoral condyle. There is intrasubstance increased T2 signal intensity of the proximal patellar tendon in keeping with patellar tendinosis. There is mild lateral patellar tilt and high riding position of the patella consistent with patella alta. The overall imaging features are in keeping with patellar tendon - lateral femoral condyle friction syndrome, with evidence of patellar mal-tracking. There are cartilaginous fissuring, delamination, and signal alteration of the patella cartilage associated with subchondral cysts consistent with grade 4 chondromalacia patella.
Case Discussion
Patellar tendon-lateral femoral condyle friction syndrome (PT-LFCFS) manifested by edema in the superolateral aspect of Hoffa's fat pad between the patellar tendon and the lateral femoral condyle. It is thought to be related to patellar maltracking and malalignment owing to the fact that most patients with PR-LFCFS have associated patella alta and lateral patellar subluxation 1.
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