Medial patellar plica syndrome

Case contributed by Matt Skalski
Diagnosis almost certain

Presentation

Right knee pain and swelling.

Patient Data

Age: 45
Gender: Male

The lateral meniscus is intact. There is a complex tear of the posterior horn of the medial meniscus, with adjacent edema within the medial aspect of the medial tibial plateau which also has minimal osteophyte proliferation. A small ganglion cyst is seen adjacent to the anterior horn of the medial meniscus.

There is increased signal within the cartilage of the medial patellar facet with underlying increased marrow signal within the patella, consistent with high grade chondrosis. The medial patellar plica is thickened and extends intraarticularly.

The anterior and posterior cruciate ligaments are intact. The deep and superficial parts of the medial collateral ligaments are intact. The iliotibial band, biceps femoris tendon, fibular collateral ligament, and popliteus tendon are intact. The extensor mechanism is unremarkable.

There is a small joint effusion. There is no Baker cyst. There is mild edema within the prefemoral fat pad.

Case Discussion

A thickened intraarticular medial patellar plica with adjacent chondrosis are findings consistent with medial patellar plica syndrome; however, the patient's meniscal tear was likely responsible for the patient's presentation in this case.

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