(Fig 4-B.26) Pre-Patellar Friction Syndrome

https://youtu.be/Ihp3N9SOBBc

https://youtu.be/w63GyfUeIyw

 

 

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📌 Pre-Patellar Friction Syndrome

✅ Anatomy:

• Superficial Layer: Transverse orientation to the patella.
• Intermediate Layer: Oblique orientation, arising from the expansion of the vastus medialis and lateralis with some contribution from the superficial fibers of rectus femoris.
• Deep Layer: The Prepatellar Quadriceps Continuation, Longitudinal orientation, formed by the deep fibers of rectus femoris, adherent to the underlying bone, and continuing inferiorly to become part of the patellar tendon.

 

✅ Clinical Features:

• Anterior knee pain during physical exertion.
• Point tenderness over the superior pole of the patella, mostly at the medial aspect.
• Caused by repetitive motion leading to the superficial and intermediate layers of the pre-patellar soft tissues rubbing against the fixed deep layer.

 

✅ Diagnosis:

• Ultrasound: Demonstrates fascial defects.
• MRI: Expected to show oedematous swelling of the pre-patellar soft tissues.
  Defects in the thinnest superficial layer observed during surgery, with possible defects in the intermediate layer.
  Inflammation in the deepest layer without tears.
• ★ Important to differentiate from pre-patellar bursitis on MRI.
  
  
  

Skeletal Radiology (2020) 49:823–836

"Visualizing MSK Radiology: A Practical Guide to Radiology Mastery"

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