Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content ++ Plica syndromePathologic plica/plicaeSynovial plica/plicae syndrome ++ 727.83 Plica syndrome ++ M67.50 Plica syndrome, unspecified knee ++ 4E: Impaired Joint Mobility, Motor Function, Muscle Performance, and Range of Motion Associated With Localized Inflammation +++ Description ++ Plica is a shelf, fold, or pleat in the synovial membrane in the knee. It is the result of incomplete or partial reabsorb during fetal development.Plica can be inferior, medial, or superior to the patella. Can vary in size (length or thickness) and clinical relevance.Plica can be thickened and inflamed, usually following acute or chronic trauma. The medial plica is most implicated.Medial plica extends from anteromedial aspect of patella to the suprapatellar pouchSuprapatellar plica separates the suprapatellar pouch from the knee jointInfrapatellar plica, also termed ligamentum mucosum, runs from the infrapatellar fat pad to the intercondylar notch +++ Essentials of Diagnosis ++ Diagnosed primarily through symptoms and exclusion of other knee pathologiesMechanism of injury can be either from chronic or acute traumaChronic: friction or rubbing over the femoral condyleAcute: pinching under the patellaFound in concurrence with range of pathologies, both chronic and acuteChronic: chondromalacia or patellofemoral pain syndromeAcute: ACL or meniscus pathologies or contusionDifferential diagnosis from other knee pathologies that may warrant a more immediate surgical intervention is essential (meniscus tear)Combination of tests/cluster of findings has been reported to have the strongest diagnostic value in terms of sensitivity (1.0) for diagnosis of medial plica syndrome. +++ General Considerations ++ Plica are normal unless thickened or inelastic from acute or chronic inflammationPlica syndrome signs and symptoms mimic other knee pathologiesFull history of symptoms, medical history screening, and differential knee orthopedic examination will ensure appropriate diagnosisHistory of anterior knee pain, pain primarily over medial femoral condyle, visible or palpable plica, and exclusion of other anteromedial knee pain. +++ Demographics ++ Plica syndrome most commonly involves the medial plica2Presence of a plica has been reported to range from 10% to > 50% in normal knees. Has been found with much greater frequency in patients who have anterior knee pain.2No delineation in incidence noted based on gender or ageIndividuals with Japanese have the highest prevalence of synovial plica in the knee. +++ Signs and Symptoms ++ Insidious onset of knee painPain or mechanical symptoms (clicking, catching, giving away) located in the anterior kneeSymptoms elicited with flexed positions of the knee; transitioning between flexion to extensionPain and mechanical symptoms with stairs; squattingTender to palpation over the plica; swelling in plica +++ Functional Implications ++ Pain/limitation with Ascending or descending stairsSitting into or rising from chairCatching or buckling of knee with Rising from seated positionsWalking ... Your Access profile is currently affiliated with '[InstitutionA]' and is in the process of switching affiliations to '[InstitutionB]'. Please click ‘Continue’ to continue the affiliation switch, otherwise click ‘Cancel’ to cancel signing in. Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Username Error: Please enter User Name Password Error: Please enter Password Forgot Password? Forgot Username? Sign in via OpenAthens Sign in via Shibboleth You already have access! Please proceed to your institution's subscription. Create a free a profile for additional features.