No lab studies were performed.
She had an x-ray which showed minimal patellofemoral joint degenerative changes.
She also had an MRI Case Photo #1 which revealed an increased trochlear groove to tibial tubercle distance, patella alta, and focal edema in the superolateral aspect of Hoffa's fat pad. These findings were consistent with a patellar tracking abnormality such as patellar tendon lateral femoral condyle friction syndrome. There was also moderate cartilage fraying and thinning of the patellar cartilage predominantly at the median ridge and lateral facet.
Dynamic ultrasound was performed in clinic, and this showed a soft tissue prominence appearing to be expelled from the lateral patellofemoral joint with flexion and extension of the right knee. It was felt that this tissue could represent a synovial proliferation. There was also prominence of the infrapatellar fat pad over the anterolateral knee.
*Please see the treatment section below for appropriate chronologic course of events.
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