Which is a common exam finding in PFPS?

Which is a common exam finding in PFPS?

• A. Excessive dynamic knee valgus during step down tasks
• B. Palpable patellar tendon thickening
• C. Pain with resisted knee flexion
• D. Sharp posterior knee pain with flexion

Answer: (D)

Dynamic knee alignment during movement is a key clue in PFPS. The most relevant exam finding is excessive dynamic knee valgus during activities that load the patellofemoral joint, such as step-downs or single-leg squats. When the knee collapses inward in flexion, the patella tracks less smoothly and experiences abnormal contact forces against the femur, increasing stress on the patellofemoral joint. This maltracking is often driven by weakness or poor control of the hip and thigh muscles, leading to lateral tracking of the patella and anterior knee pain that worsens with bending activities like stairs, squatting, or lunging. In PFPS, palpation and movement tests typically emphasize the patellofemoral area and loading patterns rather than tendon thickening or posterior knee structures. Palpable thickening of the patellar tendon fits patellar tendinopathy rather than PFPS. Pain with resisted knee flexion points more toward the hamstrings or other posterior knee structures. Sharp posterior knee pain with flexion suggests meniscal or posterior capsule/ligament issues rather than PFPS.

Dynamic knee alignment during movement is a key clue in PFPS. The most relevant exam finding is excessive dynamic knee valgus during activities that load the patellofemoral joint, such as step-downs or single-leg squats. When the knee collapses inward in flexion, the patella tracks less smoothly and experiences abnormal contact forces against the femur, increasing stress on the patellofemoral joint. This maltracking is often driven by weakness or poor control of the hip and thigh muscles, leading to lateral tracking of the patella and anterior knee pain that worsens with bending activities like stairs, squatting, or lunging.

In PFPS, palpation and movement tests typically emphasize the patellofemoral area and loading patterns rather than tendon thickening or posterior knee structures. Palpable thickening of the patellar tendon fits patellar tendinopathy rather than PFPS. Pain with resisted knee flexion points more toward the hamstrings or other posterior knee structures. Sharp posterior knee pain with flexion suggests meniscal or posterior capsule/ligament issues rather than PFPS.