Case Study:

23-year-old female ballet dancer presents with chronic dull and aching pain behind the kneecaps,
on the anterior side of the knee. Patient has been into the clinic with similar complaints multiple
times within the past 2 months. Patient indicates that she experiences a grinding feeling and
occasionally popping when walking up and down stairs and when using her pli. Palpitation
indicates an extremely tight IT band which could be a potential cause for knee pain. Movement
analysis reveals that the left knee tracks over the medial side of the foot, implying inversion
misalignment. Also claims to have stiffness and pain in front of knee after sitting with knees in
flexion for period of time longer than 30 minutes.

Initial Impression: Patellofemoral pain syndrome, (pain description, tightness in IT band)

Differential Diagnoses: Eliminate by

Knee bursitis No swelling or warmth around source of pain,
age, no joint stiffness
Patellar tendinitis No tenderness with palpitation of the insertion
of the tendon into bone, potential MRI to
detect tendon tears

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Patellofemoral pain syndrome: A condition which is usually caused by a wearing down of the
cartilage under the kneecap

Causes: Acute injury, overuse, patellar misalignment (abnormal tracking of the kneecap in the
trochlear groove), tight quadriceps, gastrocnemius and/or IT band

Symptoms: (Dull, aching pain in front of knee especially when sitting, squatting, jumping or
going down stairs, knee gives out, Popping or grinding in knee

How diagnosed: Medical history and physical examinations (palpitation) to determine origin of
pain and in some cases, imaging tests including CT scan or magnetic resonance imaging (MRI)
may be done
3
3 To relieve pain: Nonprescription anti-inflammatory drugs to decrease swelling, stiffness, and
3 pain, RICE method, physical therapy exercises (stretching to increase flexibility and decrease
3 tightness around the knee, and strengthening the quadriceps muscle), Taping or using a brace to
3 stabilize the kneecap

Differential Diagnoses: (Commonalities: dull achy pain. located around kneecap, worsened by
movement)
Knee bursitis: Inflammation of a bursa located near your knee joint. (triggered by
repetitive injury, skin redness, warmth to touch, gradually increase in pain, age)
Patellar tendinitis: Inflammation to the patellar tendon connecting the patella to the tibial
tuberosity, (swelling, dull pain on the front part of knee, can also have sharp pain)
Related anatomy of knee:
Pre-patellar bursa: Anterior bursa of the knee joint meant to
counter friction between the skin and patella.
Patellar Cartilage: flexible connective tissue
behind the kneecap which allows the patella to smoothly
glide over the femur and produce painless movement
Patellar tendon: Ligament that connects patella and tibia
and provides stability

SOURCES:
Mayo Clinic Staff Print. "Knee Bursitis." Knee Bursitis. N.p., 24 Apr. 2014. Web. 21 Nov. 2016.

Mayo Clinic Staff Print. "Patellofemoral Pain Syndrome." Patellofemoral Pain Syndrome. N.p.,
06 Jan. 2016. Web. 20 Nov. 2016.

Mayo Clinic Staff Print. "Patellar Tendinitis." Patellar Tendinitis. N.p., 08 Jan. 2016. Web. 21
Nov. 2016.

Khadavi, Michael. "Jumper's Knee vs. Runner's Knee." Sports-health. N.p., 20 Jan. 2016. Web.
21 Nov. 2016.

Hamilton, William G. "On Dance Injuries: Jumper's Knee." Dance Magazine. N.p., 26 June
2015. Web. 20 Nov. 2016.