Mediopatellar plica
definition
Under one Plica one generally understands a Skin fold, as Skin reserve is thought of in movements and regresses in the course of life. The Plica mediopatellaris is located in the area of the Knees.
As Plica in general, skin folds are used which occur in many organs of the human body. The knee also has a plica that protrudes into the knee joint. in the Normal case forms a Plica in the course of life back, but remains in its approach. Since a plica is a fold of the skin that has sufficient room to move, the skin can stretch at this point and can also be compressed, depending on the movement of the joint. The existing skin fold in the knee is also known as the plica mediopatellaris.
location
The Mediolateral plica tense in Knee joint coming from the side towards the central knee joint and looks less like one Skin fold than a tendon of a muscle. Because of the Lack of space in the knee area it can always be too complaints come, especially if the plica has not receded as intended.
complaints
Due to the close position of the skin fold to the cartilage of the knee joint and the ligament apparatus, complaints in the knee joint can arise, especially when moving. Pathological friction is responsible for this, which results from the lack of space in the knee joint.
When the knee joint is overstrained and subjected to constant stress, there may be strong friction between the skin fold and the cartilage or ligaments. Initially, no complaints are given, as cartilage and ligaments are very insensitive. In the further course, however, the friction over the cartilage can be so great that it thins out and increasingly frees up space on the bones. Once this has taken place, the plica rubs directly on the delicate bone, causing severe pain. At this point in time, the patients complain of corresponding complaints, especially after greater stress (e.g. mountain hiking or climbing stairs, but also when cycling).
As a rule, no complaints are reported at rest in the initial stage. As soon as pain occurs when moving or at rest, it is called plica syndrome.
The more cartilage is worn out, the more severe the symptoms become when you exercise and can increasingly occur at rest. In the case of severe courses, the friction, in addition to the wear and tear, leads to inflammatory processes in the knee joint, which in turn can lead to pain, but also to redness and swelling.
In addition to the chronic problems associated with plica syndrome, especially after long-term stress and overuse, acute complaints can also occur if the plica is not sufficiently regressed. With a corresponding movement, the plica becomes wedged in the joint space and is acutely squeezed. This acutely leads to severe pain in the knee joint and can also lead to impaired movement. Often, because of the new symptoms, patients adopt a relieving posture, which, if the problem is not resolved, can also lead to incorrect stress.
Further important information on the topic can be found here: painful fold of the mucous membrane in the knee
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The knee joint is one of the joints with the greatest stress.
Therefore, the treatment of the knee joint (e.g. meniscus tear, cartilage damage, cruciate ligament damage, runner's knee, etc.) requires a lot of experience.
I treat a wide variety of knee diseases in a conservative way.
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Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.
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Further information about myself can be found at Dr. Nicolas Gumpert
Diagnosis / MRI knee
The diagnosis one Plica syndrome represents a Challenge and is difficult, as numerous other causes can lead to the pain. Besides the physical exam of the knee joint, which provides only unspecific evidence of a plica syndrome, represents the Magnetic resonance imaging of the knee, the imaging of choice. It shows a clear indication of plica syndrome, especially if the Plica has already become trapped in the knee joint in acute form.
Chronic courses, so if there is only friction between the plica and cartilage, im MRI of knee not seen, at best because of the seen Tightness be suspected.
At unclear finding in the MRI should definitely be one Jointoscopy be performed. 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 mirroring and see whether it is closed Narrow between Plica and Joint space and entrapment when bending the knee joint. Often times a plica syndrome is also called Exclusion diagnosis if no other cause for the indicated pain can be found.
You can find more information on this topic at: MRI knee
Treatment of the mediopatellar plica
After the diagnosis of a plica syndrome / plica mediopatellaris a corresponding therapy first conservative respectively. On the one hand, this includes reduction the triggering one burden. The patient should rather reduce the movements and loads that lead to the pain or stop them entirely for a certain time. Furthermore, that should Knees cooled and with corresponding pain-, and anti-inflammatory drugs are supplied. As with many orthopedic diseases, medication is often used, such as Ibuprofen or Diclofenac for use and should be taken regularly for a certain period of time. This type of treatment should only be used for easier gradients just like Irritation be performed.
At severe pain as well as the Entrapment the plica should come in quickly operational approach to get voted. This is done today by means of Jointoscopy the skin fold is removed, the procedure only takes a few minutes, the full load can be carried out immediately after the removal.
Summary
Under one Plica one understands one Skin foldthat exist in some organ systems and that are in Over time increasingly regresses. In the area of Knees is sometimes a so-called Plica mediopatellaris to be found.
It forms at the inside of the knee joint and then pulls in the middle. If this Skin fold not completely receded she can have appropriate complaints cause.
At chronic courses it comes to increasing Frictions between Plica and cartilagethat stretches the inside of the joint. Due to the friction it can be too Irritation and Inflammation but also to Thinning of the cartilage come. As soon as the cartilage has worn out, it gives way to the Bones free. If the plica then begins to rub, this can result severe pain to lead. The chronic conditions are often through Overloads in the knee joint but also triggered by Incorrect loads.
Acute complaints can always go through the Entrapment the plica in the joint space are triggered. this leads to severe discomfort and does one immediate treatment necessary.
The Diagnosis Plica syndrome is not easy and is often referred to as Exclusion diagnosis if no other cause for the complaints was found. Often one comes MRI examination used as imaging. Acute entrapment can be seen here but less so friction the plica on the cartilage when it is still complete and undamaged. Here is one above all Knee arthroscopy This makes sense, since the patient's knee can also be moved during the examination and it can be seen whether the plica is trapped in the joint space. Conservative treatment options exist in the protection as well as in the medicamentous Anti-inflammatory and Pain inhibition using ibuprofen or diclofenac. If these treatments are insufficient or if the condition is acute, the plica should be surgically removed.
