Knee Pain (Pediatric)

Introduction

Chondromalacia Patella is also known as Patello-Femoral Pain Syndrome (PFPS) which is knee cap pain.  Pain in the front of the knee and around the patella (the knee cap) is a common occurrence in the growing child as well as in the adolescent years.  There are numerous factors that contribute to the development of this pain syndrome, but only rarely does it result directly from a specific injury.  Severity of pain also varies widely among patients.  It can occur only with vigorous sports participation or it can affect activities of daily living, such as sitting for prolonged periods of time, walking up and down stairs, and/or the simple task of walking around school.  Chondromalacia Patella results from micro-instability of the patella.  When the knee is extended (straight), the patella is mobile.  When flexing (bending) the knee, the patella has to find a groove in the femur (the sulcus).  In PFPS, the patella does not track perfectly and is sloppy in going down the femoral sulcus.  Over thousands and thousands of cycles, this mal-tracking softens the articular cartilage on the undersurface of the patella, producing a dull, but sometimes sharp, pain in front of the knee and around the patella.  What is unusual about the condition is that more severe pain occurs with less activity, as opposed to many conditions where activity causes pain.  Treatment depends on the severity and duration of symptoms.  Rest from excessive activities is paramount in order to control pain.

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