Diagnosis |
PAINFUL PLICA
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| Definition |
A painful plica is caused
by inflammation of a band of tissue just to the inside part of the
kneecap. |
Details |
A plica is a band of
dense scar-like tissue that occurs normally in many people. It is
left over tissue from when the knee was developing prior to birth.
Most of the time, a plica does not cause pain. |
| Causes |
A plica can become
painful after a direct blow to the front of the knee or from overuse
of the knee. Increased training for long distance running or cycling
events without proper stretching is one common cause of a painful
plica. |
| Diagnosis |
Patients with painful
plicas complain of pain in the front or just to the inner side of
their knees. Deep bending of the knee worsens the pain or may cause
the band to snap across the knee. Sitting in a car or movie theatre
may produce discomfort similar to the patellofemoral pain syndrome.
This area is also tender to the touch and a thickened cord-like
structure can usually be felt. Localized swelling may accompany the
tenderness. X-rays are taken to rule out bony causes of the pain.
Rarely, an MRI will be employed to either confirm the diagnosis or
rule out a meniscus tear on the inner part of the knee |
| Treatment |
The overwhelming majority
of painful plicas can be treated non-operatively. The treatment is
directed along a three phase protocol: control of pain and
inflammation, restoration of function and return to sports.
Flexibility of the muscles around the knee and tissues around the
kneecap are emphasized.
Rarely, arthroscopic
surgery is needed to remove the inflammed and scarred
plica to eliminate the pain.
Arthroscopic
Picture of a Plica |
| Prevention |
Maintain strong and flexible muscles around the knee, especially
quadriceps stretching
Use pads to avoid direct blows to the front of the knee
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