How is patellofemoral syndrome (PFS) diagnosed?

Updated: Sep 15, 2020
  • Author: Noel F So, MD, FAAPMR; Chief Editor: Consuelo T Lorenzo, MD  more...
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PFS is a clinical diagnosis based on history and physical examination. Plain film radiographs can assess the patella (kneecap) position. The anterior-posterior (AP) view shows the patella over the sulcus; the lateral view is imaged at 45º of knee flexion and in full extension to determine the height of the patella (ie, whether it is baja [low] or alta [high]). The sunrise view visualizes the patellofemoral articulation in the femoral condylar groove and can determine the tilt or angle of the patella, as well as demonstrate the depth of the intercondylar groove.

Advanced imaging studies such as computed tomography (CT) scanning or magnetic resonance imaging (MRI) are rarely needed but can be part of the diagnostic workup for refractory cases to ensure that there is no concurrent intra-articular disease or other contributing pathology. In addition, arthroscopic evaluation can provide assessment of joint structures that may cause symptoms that mimic PFS when they are impaired and allows for the direct visualization of the cartilage surface.

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