What is the best diagnostic test for PFPS?

What is the best diagnostic test for PFPS?

• A. Reproduction of retropatellar or peripatellar pain during squatting
• B. MRI showing trochlear dysplasia
• C. Positive Lachman test
• D. Anterior drawer test

Answer: (D)

PFPS is diagnosed mainly from clinical examination and the pattern of symptoms, not from a single imaging study. The most informative test is reproducing the patient’s pain by loading the patellofemoral joint, such as during squatting. When squatting tightens the contact between the patella and femur, it commonly provokes retropatellar or peripatellar pain in PFPS. If this pain is reliably reproduced under patellofemoral loading, it strongly supports PFPS in the right clinical context, because the syndrome is defined by pain with patellofemoral articulation and activities that load the joint. Imaging like MRI showing trochlear dysplasia is more about patellar instability and structural risk factors, not the typical PFPS presentation. Tests such as the Lachman or anterior drawer assess cruciate ligaments, not the patellofemoral joint, so they aren’t diagnostic tools for PFPS.

PFPS is diagnosed mainly from clinical examination and the pattern of symptoms, not from a single imaging study. The most informative test is reproducing the patient’s pain by loading the patellofemoral joint, such as during squatting. When squatting tightens the contact between the patella and femur, it commonly provokes retropatellar or peripatellar pain in PFPS. If this pain is reliably reproduced under patellofemoral loading, it strongly supports PFPS in the right clinical context, because the syndrome is defined by pain with patellofemoral articulation and activities that load the joint.

Imaging like MRI showing trochlear dysplasia is more about patellar instability and structural risk factors, not the typical PFPS presentation. Tests such as the Lachman or anterior drawer assess cruciate ligaments, not the patellofemoral joint, so they aren’t diagnostic tools for PFPS.