By computed tomography scan, morphology of the femur in 20 adult patie
nts with anterior knee pain was compared with that of ten volunteers w
ithout knee pain to identify femoral characteristics associated with t
he painful patella. Anteversion, measured as the difference between th
e axis of the head-neck and the axis of the posterior condyles, was si
gnificantly greater in symptomatic adults (p < 0.01). Configuration of
the distal femur and position of the patella relative to the femur we
re similar in each group. Adult anterior knee pain was, therefore, ass
ociated with increased anteversion without compensatory change in troc
hlear morphology or patellar orientation to the femur.