An irritated plica will not necessarily cause your knee to swell. Plica syndrome is an irritation of the membrane in the knee joint that keeps the joint lubricated. A plica is present in about 50% of the population and is thought to be the remnants of embryonic connective tissue that failed to fully resorb during your foetal development. This case demonstrates infrapatellar plica injury an underrated, yet common sports injury especially in soccer players. Plica syndrome is an interesting problem that occurs when an otherwise normal structure in the knee becomes a source of knee pain due to injury or overuse. Plica syndrome is usually caused by stressing or overusing your knee.
Patients can complain of pain over the anteromedial aspect of their knees and describe episodes of crepitation, catching, and pseudolocking events with activities. Welcome to specialized physical therapys patient resource about plica syndrome. These plica are membranes that should normally diminish during the second trimester of fetal development. The plica syndrome is thus often the result of excessive use of the knee and is therefore often encountered in people engaged in exercises involving repeated flexionextension movements such as the ones seen in cycling, running, team sports, gymnastics, swimming and rowing sports and is particularly common in adolescent athletes. Patellofemoral syndrome is a condition that describes pain in the front of the knee and around the kneecap, known as the patella. Xrays allow you to see bone but not soft tissue very well. Treatment of pathological synovial plicae of the knee. Iontophoresis and phonophoresis have been utilized successfully against inflammation of. During embryologic development, bands of tissue divide the limbs into joints. Clinically, 50% of patients with plica syndrome will have a history of trauma or twisting at the knee joint. This is to determine which part of the knee is injured. It is a congenital disorder in which the thin wall of fibrous tissue extends from the synovial capsule of the knee. First, the care provider may prescribe a nonsteroidal antiinflammatory medication.
However, when treating athletes with anterolateral knee pain, lateral synovial plicae should be considered. This can cause the whole knee to be painful and hard to move. Nov 21, 2017 plica knee syndrome can be painful but there are therapies and exercises that can help. Oct 11, 2017 plica syndrome causes knee pain and is basically when a part of the synovial capsule of the knee becomes irritated, enlarged, or inflamed. David geier is an orthopedic surgeon and sports medicine specialist in charleston, south carolina. There are also bursae which are fluid filled sacs which cushion the tendons and the bones. The plica is a fold of joint lining tissue that is left over from early development. There are four different plica synovial folds that can be in. Plica syndrome of the knee consists of a constellation of signs and symptoms that occurs secondary to inflammation of the plica usually caused by injury or overuse. An otherwise normal structure, a plica can be a significant source of anterior knee pain. Anterior knee injury, plica syndrome, soccer injury.
May 10, 2012 this case report is of a symptomatic posteriorlateral elbow plica in a child who presented with elbow locking. Diagnosis andtreatment ofthe plicasyndrome oftheknee. The most common symptom of medial plica syndrome is pain and tenderness along the distribution of the plica, along the medial inner side of the kneecap. Elbow synovial fold syndrome pathophysiologic features the pathophysiologic features of plica syn drome are not clearly defined. It is generally not recommended to perform a diagnostic arthroscopy to verify that a patient has an isolated medial plica irritation, because the most successful treatments for medial plica irritation are nonoperative and an. However, warming up before activity and stretching before and after activities may help to prevent medial plica syndrome. Plica syndrome is most often treated with physical therapy to improve mobility and strengthening. Plica syndrome is mainly associated with the severe pain that is being felt at the anterior location of the knee. It results in achy knee pain which gets worse with activity, particularly up and down stairs, a feeling of instability in the knee and sometimes a catching or locking sensation. Add sportspecific exercises as tolerated cycling, elliptical, running as tolerated phase iii 412 weeks full none full advance sportspecific exercises as tolerated maintenance core, glutes, hip and balance program. Activities that repeatedly bend and straighten the knee, such as running, cycling, or swimming can also irritate the medial plica and cause plica syndrome. Most cases of plica syndrome respond well to physical therapy or a home exercise program.
Printable orthopaedic patient education orthoinfo aaos. If your knee isnt getting better your knee pain could be plica syndrome. It has been well connected with the presence of appendix in the body for the reason that according to studies, the mere presence and absence of plica in the body just like an appendix seems insignificant. Jul 07, 2017 signs and symptoms of plica syndrome in the knee typically athletic individuals with plica syndrome complain of pain on the medial side of the knee, just inside of the patella kneecap. Plica syndrome description the plica is a fold of joint lining that is a remnant of tissue from development. A torn medial meniscus, osteochondral defects, inflammation, or. Evaluation, treatment, and rehabilitation implications of. Plica syndrome the plica is a fold of joint lining synovial tissue that is a remnant of tissue from embryological development. Plicae are small folds in the synovial membrane, the thin structure that surrounds. Handouts can be printed and used as they areor they can be easily customized with a practice logo.
Apr 20, 2020 plica syndrome of the knee is a constellation of signs and symptoms that occur secondary to injury or overuse. Mri, cat scans and xrays exercises for lumbar facet. The plica is an extension of the synovial membrane in the knee. Plica syndrome of the knee consists of a constella tion of signs and symptoms that occurs secondary to inflammation of the plica usually caused by inju. The knee is a big strong joint, and is formed of the tibia shin bone and femur thigh bone. This involves maintaining normal knee joint alignment, adequate strength and flexibility in the muscles around the knee joint plus the rest of the lower limb. Intraarticular injection was provided and he noted relief for about 2 weeks. The primary goal is to reduce inflammation of the synovial tissue and thickening of the plica. Plica syndrome is a pathologic process due to inflammation of synovial plicae. Some researchers have hypothesized that it has a biomechanical role, while others suggest it is a reservoir for reparative cells.
Plica syndrome treatment focuses on decreasing inflammation of the synovial capsule. Treatment for plica syndrome should focus on decreasing the inflammation of the synovial capsule. Pdf clinical management of medial patellar plica syndrome. Synovial plicae knee 2 public playlist includes this case. Patellofemoral syndrome pfs is an irritation under the knee cap patella and the surrounding tissues due to increased compression. There can be pain around or under the kneecap and sometimes in the back of the knee. The etiology is thought to be related to repetitive microtrauma resulting. Arthroscopic removal of the plica may be necessary when conservative treatment for up to 6 months. It is often necessary to stop exercises such as cycling, running and swimming while the plica heal and until pain and inflammation are reduced. When this tissue on the inside of the kneecap becomes irritated, it results in knee pain and tenderness to touch. During development, bands of tissue divide the limbs into joints.
Mr images demonstrated thickening of a posteriorlateral plica between the radius and capitellum of the elbow. It can become inflamed or irritated following trauma or an increase in physical activity. The plica on the inner side of the knee, called the medial plica, is the synovial tissue most prone to irritation. We present the case of a 17 year old female with elbow synovial fold syndrome aka plica synovialis. A series of printable pdf handouts addressing some of the most common musculoskeletal conditions and treatments in plain, straightforward language. During embryological development, bands of tissue divide the limbs into joints. The diagnosis can sometimes be difficult, but if this is the source of your knee pain, it can be easily treated. Activities that repeatedly bend and straighten the knee, such as running, biking, or use of a stairclimbing machine, can irritate the medial plica and cause plica syndrome. There are four different plica synovial folds that can be in the human knee. Often the result of overuse, plica syndrome may also result from a directhit injury. Treatment knee plica problems usually get better without surgery. Even though an xray cant show knee plica syndrome, the doctor may want you to get one anyway to rule out other knee problems. Synovial plicae are frequently asymptomatic, but can become diseased with trauma and overuse.
The medial plica syndrome is an interesting problem that occurs when an otherwise normal structure in the knee becomes a source of knee pain due to injury or overuse. A nonsteroidal antiinflammatory drug nsaid is often used in conjunction with therapeutic exercise and modalities. Aug 24, 2009 there is a syndrome that is caused by the irritation and resultant inflammatory reaction of the relic of the synovial plica of the knee that is known as pathological synovial plica syndrome. If you get any of these symptoms remove the ice pack immediately. The plica on the inner side of the knee, called the medial plica, is the synovial tissue most prone to irritation and injury. When the knee is bent, the medial plica is exposed to direct injury, and it may also be injured in overuse syndromes. This will help take pressure off the knee joint in general. Pain usually occurs when the synovial capsule becomes inflamed. This is a common intervention for patella plica syndrome when initiation of therapy exercises and activity modification is not sufficient and the patient has continued symptoms schindler, 2014. Patients with pathological synovial plica syndrome have a very characteristic clinical presentation, and their symptoms are always related to physical activity. Pdf a 10year followup on arthroscopic medial plica. Pes anserinus syndrome is caused by walking for an extended period on uneven or sloped surfaces, muscular imbalances, worn out running shoes, onesided training, pelvic instability, or gait problems knock knees. Therapeutic exercise and modalities may also be used to treat the plica. A plica is a thin wall of synovial joint tissue that is an extension of the synovial capsule of the knee.
These bands may persist into adulthood in up to 60 percent of people, although it infrequently causes symptoms. Symptoms the symptoms of plica syndrome are very similar to those of other knee injuries and therefore it can be very difficult to diagnose. Pieces of synovial plica are remnants from early fetal development. This band of tissue infrequently causes symptoms several different band types may exist.
Plica syndrome causes knee pain and is basically when a part of the synovial capsule of the knee becomes irritated, enlarged, or inflamed. Nov 27, 2007 medial plica irritation of the knee is a very common source of anterior knee pain. Usually, physical therapy exercises for plica syndrome involve strengthening the muscles next to the knee, including not only the quadriceps and hamstrings, but also the adductors and abductors. Pdf synovial plicae are thickenings of the synovial knee.
Physical therapy in omaha for knee pain plica syndrome. Activities that repeatedly bend and straighten the knee, such as running, biking, or use of a stairclimbing machine, can irritate the medial. There may also be a snapping sensation along the inside. Plica syndrome description the plica is a fold of joint lining synovial tissue that is a remnant of tissue from embryologic development. Plica syndrome can cause anterior knee pain and a popping sensation in the knee that is due to a thick, fibrous plica snapping over the femoral condyle. The exact role of the ifp is not completely understood. When the pouches do not combine to form a synovial cavity, the plica remain. Natural cure for plica syndrome and alternative treatments.
Plica syndrome is a condition caused by inflammation in the lining of the knee joint. Cole,md,mba weight bearing brace rom exercises phase i 02 weeks as tolerated none as tolerated heel slides, quadhamstring sets, slr, planks, bridges, abs, stepups and stationary bike as tolerated phase ii 24 weeks. Surgery confirmed a thickened and inflamed posteriorlateral plica, which was resected with subsequent improvement of the childs symptoms. Once the initial injury is resolved, a patient maybe asymptomatic for a period of time, only to report back to the. Iontophoresis and phonophoresis have been utilized successfully against inflammation of the plica and synovial capsule. During embryologic development, bands of tissue divide your knee into joints and these bands often remain in your joints as you develop and grow. Failing these, surgical removal of the plica of the affected. It is usually associated with palpation on the medial patellofemoral joint. There are many causes for anterior knee pain in the athlete. Mris and xrays may be needed to rule out other conditions. To prevent inflammation, apply a bag of crushed ice or frozen. When the plica becomes irritated and inflamed, the condition called plica syndrome results. Lateral synovial plica syndrome is a rare condition.
There are various fatty pads around the knee which help cushion the overlying tendons. Plica knee syndrome can be painful but there are therapies and exercises that can help. The incidence of individuals with plica syndrome is under controversy, and some surgeons believe it is overdiagnosed. It can help to determine the level of degeneration in the facets, and see how much of the disc is left. Patellofemoral syndrome symptoms, exercises, and treatment. Plica syndrome of the knee occurs when synovial tissue bands become irritated from injury or overuse. The first symptom is often initial pain at the beginning of the workout, which then fades. Plica syndrome diagnosis diagnosis for plica syndrome is mostly based on the patients medical history as well as a physical exam conducted by a doctor to determine what hurts and where. Elbow synovial fold syndrome is usually an isolated condition.
Pdf plica syndrome is a pathological condition secondary to inflammation. These bands may persist into adulthood in up to 60% of people, although it infrequently causes symptoms. Plica syndrome of the knee orthopedic specialists of seattle. Oct 30, 2017 plica syndrome is usually caused by stressing or overusing your knee. This is often caused by exercises that require you to frequently bend and straighten your knee, such as running, biking, or. Running or jumping walking when it is flared up sitting going up or down stairs.
A plica is a fold of synovial membrane most commonly in the anteromedial aspect of the knee. There are only a few cases reported in the literature of elbow synovial fold syndrome associated with other abnormalities, such as posterolateral instability, medial collateral ligament injury, lateral epicondylitis, cubital neuropathy, or loose bodies 1, 5. Plica syndrome arises from an injury, such as a direct blow, re petitive microtrauma, and overloading e. It is characterized by supra and midpatellar pain with knee extension as well as the presence of audible cracking noises with knee flexion and. This can occur over a long period of time, such as when the plica is irritated by certain exercises, repetitive motions, or kneeling. Physical therapy in baton rouge for knee pain plica syndrome. These bands may persist into adulthood in up to 60% of people. The pain is due to the plica catching, rubbing or being pinched between the kneecap and thigh bone. If all conservative treatment options have been taken and the child is still experiencing pain, then arthroscopic surgery can be performed to remove the plica completely. Physical therapy in oakland for knee pain plica syndrome. The primary symptom caused by plica syndrome is pain.
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