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Patellar tendinitis, also known as jumper's knee, is an overuse injury of the tendon that straightens the knee. [1] Symptoms include pain in the front of the knee. [1] Typically the pain and tenderness is at the lower part of the kneecap, though the upper part may also be affected. [2] Generally there is no pain when the person is at rest. [2]
Malalignment of the patella or abnormal patellar tracking as it moves through the femoral groove. [ 7 ] People with genu valgum have larger than normal Q-angles causing the weight-bearing line to fall lateral to the centre of the knee causing overstretching of the MCL and stressing the lateral meniscus and cartilages.
Risk factors include patellar tendinitis, kidney failure, diabetes, and steroid or fluoroquinolone use. [1] [2] There are two main types of ruptures: partial and complete. [1] In most cases, the patellar tendon tears at the point where it attaches to the knee cap. [1] Diagnosis is based on symptoms, examination, and medical imaging. [1]
Complications may include an inability to fully straighten the knee. [2] The underlying mechanism may involve bleeding, inflammation, or insufficient space for the fat pad. [2] This may occur as a result of trauma or surgery to the knee. [1] Diagnosis may be supported by magnetic resonance imaging (MRI). [2]
A knee X-ray and/or blood test – this can assist to exclude certain types of arthritis or inflammation. Magnetic Resonance Imaging – to observe cartilage condition and assess deterioration; Arthroscopy – a low invasive approach to image the inside of the knee joint by inserting an endoscope into the knee joint. [16]
Knee MRIs should be avoided for knee pain without symptoms or effusion, unless there are non-successful results from a functional rehabilitation program. [25] In some diagnosis, such as in knee osteoarthritis, magnetic resonance imaging does not prove to be clear for its determination. [26]
The patellar tendon is a strong, flat ligament, which originates on the apex of the patella distally and adjoining margins of the patella and the rough depression on its posterior surface; below, it inserts on the tuberosity of the tibia; its superficial fibers are continuous over the front of the patella with those of the tendon of the quadriceps femoris.
When the deep bursa is involved, bending the knee generally increases the pain. [2] Other conditions that may appear similar include patellar tendonitis and prepatellar bursitis. [5] Treatment is generally by rest, alternating between ice and heat, and NSAIDs. [1] Infrapatellar bursitis is relatively rare. [4]