Knee Plica and Knee pain - Everything You Need To Know - Dr. Nabil Ebraheim

13- Knee Plica and Knee pain:
Dr. Ebraheim’s educational animated video illustrates the knee examination for medial plica of the knee . knee plica video that explains knee pain examination ,knee pain treatment and knee pain surgery .knee pain diagnosis of plica is easy . Meniscus tear or injury should be excluded as part of the diagnosis.
Painful knee plica is rare and is a diagnosis of exclusion.
The majority of knee plica are medial.
So what is knee plica?
- It is an embryological remnant of the synovial folds.
- The synovial folds can become thickened and sometimes inflamed.
- Occurs in 50% of the patients due to blunt trauma to the knee.
- The knee plica can be suprapatellar or infrapatellar, mostly medial.
- It is located over the medial femoral condyle and is vulnerable to trauma when the knee is flexed.
- Repeated trauma or irritation may lead to inflammation and fibrosis of the plica.
- When fibrosis occurs in the plica, this decreases the elasticity and causes impingement on either the patella or the medial femoral condyle.
- Synovitis or chondromalacia may occur on the leading edge of the medial femoral condyle.
Evaluation of the plica:
- Diagnosis is usually done by exclusion.
- There is usually an activity related antero- medial or medial knee pain.
- Some catching or giving way of the knee.
- The patient may feel a snapping sensation or pain with repeated activity.
- You may sometimes feel this band of tissue that is the medial plica (may role it under the finger).
- This band of tissue is sometimes painful.
- The presence of plica does not mean that it will make pathology or create symptoms.
How do you locate this Plica?
The plica can be palpated just above the joint line.
The palpation is facilitated by having the patient flex and extend the knee while the physician palpates the medial femoral condyle next to the patella.
MRI to the knee might not detect the Plica.
Treatment:
• Rest
• NSAIDS
• Activity modification
• Physical therapy modalities
- Ultrasound or Lontophoresis.
• Steroid injection.
If these treatment methods fail, then resection of the plica could be done (rarely done but is very effective).
Make sure to check for saphenous neuritis as a differential diagnosis.



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