Practical assessment for PFP

Anterior knee pain assessment begins by excluding several local structures that may be producing symptoms. The examination first focuses on the patellar tendon by palpating around the inferior pole of the patella and checking whether pressure reproduces the person’s familiar pain. The quadriceps tendon is then assessed at the superior border of the patella, followed by Hoffa’s fat pad, which is tested by applying pressure on either side of the patellar tendon while moving the knee into extension. The summary then moves to the menisci, which can sometimes refer pain into the front of the knee. Deep knee flexion combined with tibial rotation and joint line palpation is used to stress the posterior horns of the medial and lateral meniscus and assess symptom reproduction. Cruciate ligament integrity is also considered, since ACL or PCL instability may contribute to anterior knee pain. Lachman, anterior drawer, and reverse Lachman-type testing are used for this purpose. Finally, the assessment explores patellofemoral pain by palpating the medial patellofemoral ligament and patellar facets during patellar glides. Clarke’s test is mentioned as a possible provocation test, though its limited specificity means false positives are common.