In the asymptomatic control group, there were 37 knees without a plica echo, 16 knees with a plica echo that met one criterion, and seven knees that met two criteria.ĭynamic sonography allows detection of abnormalities of medial plicae in the knee, with good sensitivity and specificity. Pain increases with activity, especially when knee flexion and extension are required. The main complaint is an intermittent, dull, aching pain in the area medial to the patella above the joint line and in the supramedial patellar area. Diagnostic accuracy was 88%, sensitivity was 90%, and specificity was 83%. Medial plica irritation of the knee is a common source of anterior knee pain. Medial plicae with pathologic findings were absent in 23 knees 19 plicae were correctly diagnosed by using sonography. An asymptomatic control group consisting of 32 volunteers (mean age, 28 years range, 10-52 years) and 60 knees was also assessed.Īrthroscopy revealed 68 plicae with pathologic findings, 61 of which met all three sonographic criteria. Three sonographic criteria were assessed during patellar movement by using a 12-MHz 38-mm linear transducer: (a) continuous echo sliding over the medial femoral condyle during medial and lateral movement of the patella, (b) entry of the echo under the patella during medial movement of the patella, and (c) pain or discomfort during dynamic sonography. A prospective evaluation in 88 subjects (56 female subjects, 32 male subjects mean age, 20 years range, 7-47 years) who were suspected of having a medial plica and 91 knees was performed. Exclusion criteria were a history of trauma with hemarthrosis, previous knee surgery, and arthrosis detectable on radiographs. Inclusion criteria were a palpable medial band, history of painful aching, and giving way or locking, which limited the subject's activity for at least 6 months. The study design was approved by the university bioethics board, and all the participants gave informed consent. To perform a feasibility study of dynamic sonography for the diagnosis of medial plica syndrome of the knee.
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