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Sports Medicine

Knee pain

11/06/2006

Question:

I am a male, over 58. I am not overweight and have had no obvious injuries. My knee is not swollen and there are no visible symptoms. I can exercise, walk, and sit (generally) with no pain. The trouble happens when I sit in a theater with cramped leg room for an extended period of time. After about thirty minutes or so my left knee becomes extremely painful. When I stand and walk around again the pain disappears. In circumstances where I sit but can extend my leg (at work, home, etc.) there is no problem.

Answer:

Your knee pain symptoms are classic for patellofemoral pain, also referred to as "chondromalacia patellae", since you describe what's known as a "positive theater sign": knee pain which occurs, or is worse, when sitting with the knee bent in situations where there isn't room to straighten the knee (which would reduce or relieve the pain). Patellofemoral pain involves the front of the knee around the kneecap (patella). When the knee is bent, there are increased contact forces or pressure between the patella and the underlying femur (thighbone), which may cause pain if there is inflammation in this part of the knee.

Since you describe your pain severity as being extreme, to determine if your symptoms are indeed patellofemoral pain - as well as why your right knee doesn't bother you when patellofemoral pain most frequently affects both knees - you should undergo a medical evaluation for a proper diagnosis and treatment plan.

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Response by:

Brian L Bowyer, MD Brian L Bowyer, MD
Clinical Associate Professor
Physical Medicine & Rehabilitation
College of Medicine
The Ohio State University