Physical Examination of the Patellofemoral Joint

Abstract

Disorders of the patellofemoral joint have often posed a diagnostic dilemma for the treating physician. Typically, patients with patellofemoral disorders present with anterior knee pain, but these patients also often complain of aching pain medially as well as posteriorly. The pain can be aggravated by prolonged sitting with the knee in a flexed position (movie sign), stair climbing, or a sudden change in activity level. The nature of these symptoms as well as others such as catching, locking, or giving way are nonspecific and often lead to difficulty differentiating patellofemoral disorders from other internal derangements of the knee. Careful attention to detail during the history and physical examination will normally allow the examiner to isolate the patellofemoral joint as the source of the problem. It is important to also recognize that the patellofemoral joint can be affected by local as well as remote conditions.¹