What are the causes of lateral patellar (kneecap) pain?

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Differential Diagnosis for Lateral Patella Pain

  • Single most likely diagnosis
    • Patellofemoral Pain Syndrome (PFPS): This is the most common cause of lateral patella pain, often related to overuse, poor tracking of the patella, or biomechanical issues such as excessive pronation or supination of the foot. It is characterized by pain around or behind the patella, especially when going up or down stairs, squatting, or jumping.
  • Other Likely diagnoses
    • Iliotibial (IT) Band Syndrome: Friction and inflammation of the iliotibial band as it moves over the lateral femoral condyle can cause lateral knee pain, including around the patella. This is common in runners and cyclists.
    • Lateral Meniscus Tear: Tears in the lateral meniscus can cause pain on the lateral side of the knee, including the area around the patella. This is often associated with a traumatic event or degenerative changes.
    • Patellar Tendinopathy: While more commonly associated with pain below the patella, some cases can present with lateral patella pain due to the tendon's attachment points and the surrounding soft tissue involvement.
  • Do Not Miss diagnoses
    • Osteonecrosis of the Femoral Condyle: A condition where the blood supply to the bone is interrupted, leading to bone death. It can cause severe pain and must be identified early to prevent further damage.
    • Septic Arthritis: An infection within the joint space, which is a medical emergency requiring prompt diagnosis and treatment to prevent long-term joint damage.
    • Tumor (e.g., Osteoid Osteoma): Although rare, bone tumors can cause localized pain and must be considered in the differential diagnosis to ensure timely and appropriate management.
  • Rare diagnoses
    • Binding-Larson-Johansson Syndrome: A rare condition involving inflammation of the proximal patellar tendon and the tibial tubercle apophysis, more commonly seen in adolescents.
    • Sinding-Larsen-Johansson Syndrome: Similar to the above but involves the distal patellar tendon and is considered a rare cause of knee pain in adolescents.
    • Hoffa's Syndrome: Inflammation of the infrapatellar fat pad, which can cause anterior knee pain but can sometimes be perceived as lateral patella pain due to referred pain patterns.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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