Laboratory Studies

See the list below:

Laboratory studies are not indicated for patellofemoral joint syndromes, unless there is a need to rule out other potential causes, such as systemic, inflammatory, or metabolic disease.
- Erythrocyte sedimentation rate (ESR) is elevated in an inflammatory process.
- Liver and renal function may be abnormal in metabolic disease.
- Antibody tests are elevated for rheumatoid arthritis or ankylosing spondylitis.
- Knee aspirates show an elevated white blood cell (WBC) count in an inflammatory process, an abnormal Gram stain and culture in infection, and crystals when crystal arthropathy is present.

Imaging Studies

See the list below:

Radiographic imaging is not necessary to make the diagnosis of patellofemoral joint syndrome, but these studies can be helpful to the physician when excluding other potential causes (see Differentials and Other Problems to Be Considered). Particular findings can support the diagnosis, including the following:
- Lateral plain films show the presence of patella alta or patella baja.
- A sunrise or Merchant's view reveals lateral tilt and the relative height of the femoral condyles.
- Magnetic resonance imaging (MRI), computed tomography (CT) scanning, and bone scanning are not needed in the evaluation of patellofemoral joint syndromes, but these imaging modalities may be used to evaluate other pathologic conditions of the knee if the diagnosis is in doubt. Dynamic CT scanning, 0-120 º, is useful in assessing patellar tracking in recalcitrant cases in which surgery is being considered. This study can be used in the rare patient who is suspected of having a patellar tilt or subluxation but whose radiographs are normal.

Other Tests

A study reported that the use of surface electromyography signals (B2-frequency band of 45-96 Hz) of the vastus lateralis and vastus medialis muscles with referred anterior knee pain can provide diagnostic accuracy of patellofemoral pain syndrome.^[13]

Treatment & Management

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Author

Jane T Servi, MD Consulting Staff, Northern Colorado Orthopedic Associates

Jane T Servi, MD is a member of the following medical societies: American Academy of Family Physicians, American College of Sports Medicine, American Medical Society for Sports Medicine

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Russell D White, MD Clinical Professor of Medicine, Clinical Professor of Orthopedic Surgery, Department of Community and Family Medicine, University of Missouri-Kansas City School of Medicine, Truman Medical Center-Lakewood

Russell D White, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Family Physicians, American Association of Clinical Endocrinologists, American College of Sports Medicine, American Diabetes Association, American Medical Society for Sports Medicine

Disclosure: Nothing to disclose.

Chief Editor

Craig C Young, MD Professor, Departments of Orthopedic Surgery and Community and Family Medicine, Medical Director of Sports Medicine, Medical College of Wisconsin

Craig C Young, MD is a member of the following medical societies: American Academy of Family Physicians, American College of Sports Medicine, American Medical Society for Sports Medicine, Phi Beta Kappa

Disclosure: Nothing to disclose.

Additional Contributors

Andrew L Sherman, MD, MS Professor, Interim Department Chair and Vice Chair of Education, Department of Physical Medicine and Rehabilitation, University of Miami, Leonard A Miller School of Medicine; Interim Chief Medical Officer, Christine E Lynn Rehabilitation Center for the Miami Project to Cure Paralysis and Jackson Health System

Andrew L Sherman, MD, MS is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, American Association of Neuromuscular and Electrodiagnostic Medicine, Association of Academic Physiatrists, Florida Society of Physical Medicine and Rehabilitation

Disclosure: Nothing to disclose.