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Patellofemoral pain syndrome

Última revisão: 20 Aug 2025
Última atualização: 10 Jan 2025

Resumo

Definição

História e exame físico

Principais fatores diagnósticos

  • ill-defined ache
  • pain aggravated by compressive force
  • Q angle
  • pain on palpation of patellar retinaculum
  • patellar tilt test
  • mediolateral glide test
  • patellar mobility test
  • patellar apprehension test
  • patellar maltracking test
  • decreased muscle flexibility
  • muscle weakness
Detalhes completos

Fatores de risco

  • bony and structural abnormalities
  • iliotibial band tightness
  • abnormal patellar mobility
  • quadriceps muscle weakness
  • subtalar joint pronation
  • hip internal rotation
  • gait deviations
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • no initial test
Detalhes completos

Investigações a serem consideradas

  • knee x-ray
  • MRI
  • kinematic MRI or CT
Detalhes completos

Algoritmo de tratamento

Inicial

acute pain

AGUDA

abnormal patellofemoral joint mechanics

lower kinetic chain problems

overuse in athletes

CONTÍNUA

post initial and reactivation-phase treatment

Colaboradores

Autores

Michael Fredericson, MD, FACSM
Michael Fredericson

Associate Professor and Director

Physical Medicine & Rehabilitation Clinics

Stanford University

Stanford

CA

Declarações

MF declares that he has no competing interests.

Agradecimentos

Dr Michael Fredericson would like to gratefully acknowledge Dr Jong In Lee and Dr Julia Arroyo, previous contributors to this topic. JIL and JA declare that they have no competing interests.

Revisores

John Cianca, MD

Clinical Associate Professor

Department of Physical Medicine & Rehabilitation

Baylor College of Medicine

Houston

TX

Declarações

JC declares that he has no competing interests.

John Halperin, MD

Physician

Sharp Rees-Stealy Medical Group

La Mesa

San Diego

CA

Declarações

JH declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Referências

Nossas equipes internas de editoria e de evidências trabalham em conjunto com colaboradores internacionais especializados e pares revisores para garantir que forneçamos acesso às informações o mais clinicamente relevantes possível.

Principais artigos

Fredericson M, Powers CM. Practical management of patellofemoral pain. Clin J Sport Med. 2002;12:36-38. Resumo

Earl JE, Vetter CS. Patellofemoral pain. Phys Med Rehabil Clin N Am. 2007;18:439-458,viii. Resumo

Fredericson M, Yoon K. Physical examination and patellofemoral pain syndrome: a review. Am J Phys Med Rehabil. 2006;85:234-243. Resumo

American College of Radiology. ACR Appropriateness Criteria. Chronic knee pain. 2018 [internet publication].Texto completo

Collins NJ, Bisset LM, Crossley KM, et al. Efficacy of nonsurgical interventions for anterior knee pain: systematic review and meta-analysis of randomized trials. Sports Med. 2012;42:31-49. Resumo

Artigos de referência

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