Uncommon causes of anterior knee pain - A case report of Infrapatellar contracture syndrome

The uncommon causes of anterior knee pain should always he considered in th e differential diagnosis of a painful knee when treatment of common origins become ineffective. A case is presented in which the revised diagnosis of infrapatellar contracture syndrome was made after noting delayed progress i n the rehabilitation of an active female patient with a presumed anterior h orn medial meniscus tear and a contracted patellar tendon. The patient impr oved after the treatment program was augmented with closed manipulation und er arthroscopy and infrapatellar injection of both corticosteroids and a lo cal anesthetic. Infrapatellar contraction syndrome and other uncommon sourc es of anterior knee pain, including arthrofibrosis, Hoffa's syndrome, tibia l collateral ligament bursitis, saphenous nerve palsy, isolated ganglions o f the anterior cruciate ligament, slipped capital femoral epiphysis, and kn ee tumors, are subsequently discussed. Delayed functional advancement in a rehabilitation program requires full reassessment of the patient's diagnosi s and treatment plan. Alternative diagnoses of knee pain are not always of common origins. Ample knowledge of uncommon causes of anterior knee pain is necessary to form a full differential diagnosis in patients with challengi ng presentations.