Diagnostic MRI of the knee
The diagnosis of a plica syndrome is challenging and difficult, as the pain can have many other causes. In addition to the physical examination of the knee joint, which only provides unspecific indications of a plica syndrome, magnetic resonance imaging of the knee is the imaging of choice. It provides a clear indication of a plica syndrome, particularly if the plica has already become acutely trapped in the knee joint.
Chronic progressions, i.e. when there is only friction between the plica and the cartilage, cannot be seen in the MRI of the knee, at best it can only be suspected on the basis of the amount of bursting seen. If the MRI findings are unclear, a joint endoscopy should be performed in any case. This so-called arthroscopy has several advantages.
On the one hand, it provides real images and shows the inside of the knee joint 1:1, on the other hand, the examiner can move the knee during the endoscopy and thus see whether there are any tight spots between the plica and the joint space and whether the knee joint is jammed during flexion. Often a plica syndrome is also diagnosed as exclusionary if no other cause for the stated pain can be found. You can find more information on this topic at MRI Knee
Treatment of Plica mediopatellaris
After the diagnosis of a plica syndromePlica mediopatellaris, a corresponding therapy can initially be performed conservatively. This includes, on the one hand, the reduction of the triggering stress.The patient should reduce the movements and strains that lead to the pain or stop them completely for a certain time. Furthermore, the knee should be cooled and treated with appropriate pain and anti-inflammatory drugs.
As with many orthopedic diseases, drugs such as ibuprofen or diclofenac are often used and should be taken regularly for a certain period of time. However, this type of treatment should only be carried out in cases of mild progressions and irritation. In the case of severe pain or if the plica becomes trapped, a surgical procedure should be chosen without delay. Today, the skin fold is removed by means of arthroscopy, the procedure takes only a few minutes, and full weight bearing can be performed immediately after the removal.
