🦵 Section 718.5 · Patellofemoral Pain Syndrome (PFPS)

Nelson Textbook of Pediatrics 22nd Edition | PFPS: anterior knee pain around or behind the patella, without instability. "Theater sign" — pain with prolonged sitting (knee flexion). Affects 6-7% of adolescents, up to 25% of teen athletes. Female predominance (55-62%). Pathophysiology: multifactorial — abnormal patellar tracking, muscle imbalance (weak VMO, tight lateral structures), hip weakness. Treatment: physical therapy (VMO strengthening, hip/core strengthening, quad/hamstring stretching), activity modification. Surgery rarely necessary.

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📋 30 Clinical Scenarios — Patellofemoral Pain Syndrome

📇 High‑Yield Review Cards

🩺 Clinical Recognition: Patellofemoral Pain Syndrome

Select a presentation to review diagnostic clues and management per Nelson 718.5.

📋 Stepwise Management of Patellofemoral Pain Syndrome

🔑 Key Principles — Nelson Section 718.5
• Definition: Anterior knee pain around/behind patella, without instability. Diagnosis of exclusion.
• Epidemiology: 6-7% of adolescents, up to 25% of teen athletes. Female predominance (55-62%).
• Classic symptom: "Theater sign" — pain with prolonged sitting (knee flexion). Worse with stairs, squatting, running.
• Pathophysiology: Multifactorial: quadriceps weakness (especially VMO), tight lateral structures, hip abductor weakness, poor core stability, overpronation.
• Treatment: Physical therapy is mainstay — VMO strengthening, hip/core strengthening, quad/hamstring stretching, activity modification. Surgery rarely necessary.

    ⚡ Reflex Prompts — Clinical Decisions

    📖 Summary: Patellofemoral Pain Syndrome (Nelson 718.5)