Summary
Definition
History and exam
Key diagnostic factors
- dor mal definida
- dor agravada por força compressiva
- Ângulo Q
- dor à palpação do retináculo patelar
- teste da inclinação patelar
- teste de deslize médio-lateral
- teste da mobilidade patelar
- teste de apreensão patelar
- teste de mau ajuste patelar
- diminuição da flexibilidade muscular
- fraqueza muscular
Risk factors
- anormalidades estruturais e ósseas
- contratura da banda iliotibial
- mobilidade patelar anormal
- fraqueza muscular no quadríceps
- pronação da articulação subtalar
- rotação interna do quadril
- desvios de marcha
Diagnostic tests
1st tests to order
- nenhum exame inicial
Tests to consider
- radiografia do joelho
- RNM
- RNM cinemática ou tomografia computadorizada (TC)
Treatment algorithm
dor aguda
mecânica anormal da articulação patelofemoral
problemas na cadeia cinética inferior
uso excessivo em atletas
tratamento pós-inicial e da fase de reativação
Contributors
Authors
Michael Fredericson, MD, FACSM

Associate Professor and Director
Physical Medicine & Rehabilitation Clinics
Stanford University
Stanford
CA
Disclosures
MF declares that he has no competing interests.
Acknowledgements
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.
Peer reviewers
John Cianca, MD
Clinical Associate Professor
Department of Physical Medicine & Rehabilitation
Baylor College of Medicine
Houston
TX
Disclosures
JC declares that he has no competing interests.
John Halperin, MD
Physician
Sharp Rees-Stealy Medical Group
La Mesa
San Diego
CA
Disclosures
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.
References
Key articles
Fredericson M, Powers CM. Practical management of patellofemoral pain. Clin J Sport Med. 2002;12:36-38. Abstract
Earl JE, Vetter CS. Patellofemoral pain. Phys Med Rehabil Clin N Am. 2007;18:439-458,viii. Abstract
Fredericson M, Yoon K. Physical examination and patellofemoral pain syndrome: a review. Am J Phys Med Rehabil. 2006;85:234-243. Abstract
American College of Radiology. ACR Appropriateness Criteria. Chronic knee pain. 2018 [internet publication].Full text
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. Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Síndrome da banda iliotibial
- Síndrome plica
- Tendinopatia/tendinite patelar
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