Sonography has a limited role in the evaluation of synovial plicae because of its inherent asymptomatic and symptomatic synovial plicae of the knee joint. Aug 24, 20 bilateral lateral synovial plicae presentation, an uncommon condition. Suprapatellar plica syndrome was considered when 1 the patient. The infrapatellar plica is also called as ligamentum mucosum, plica synovialis infrapatellaris, inferior plica or anterior plica. All books are in clear copy here, and all files are secure so dont worry about it. During the fetal stage you have three capsules, called the synovial plicae, that grow around the developing knee joint. Plica syndrome treatment focuses on decreasing inflammation of the synovial capsule. Plica syndrome is most often treated with physical therapy to improve mobility and strengthening at the knee to decrease tension and irritation. The synovial membrane encloses the knee joint and contains the fluid that keeps the joint lubricated. The plica is a fold in the membrane surrounding your knee joint. Three such folds are found with regularity in the human knee, but most are asymptomatic and of little clinical consequence. The superior plica also is referred to as plica synovialis suprapatellaris, suprapatellar plica, superomedial plica, or medial suprapatellar plica.
The plicae originates proximally with the genu articularis muscle and runs along the medial femoral condyle to insert on the intraarticular synovial lining of the knee. The fibrotic changes in the joint can eventually lead to softening and degeneration of the cartilage at the patellofemoral complex. Plica syndrome of the knee is a constellation of signs and symptoms that. Pdf to investigate and evaluate the prevalence of 4 kinds of synovial plicae named according to patella, which are inferior, medial, lateral and. Whit ewing, md a plica synovialis is a membranous fold or ridge found in the synovial lining of a joint.
Treatment of pathological synovial plicae of the knee. Any type of dysfunction of the patellofemoral joint may cause irritation of the medial synovial plica. This can occur from a fall or even from hitting the knee on the dashboard during an automobile accident. The plica on the inner side of the knee, called the medial plica, is the synovial tissue most prone to irritation. This site is like a library, you could find million book here by using search box in the header. Synovial plicae represent inward folds of the synovial lining of the knee joint capsule, which are considered vestiges of a membranous knee joint partition present during foetal development. Athletes at nsk for symptomatic medial plica include bicyclists, runners, rowers, and others where direct. Jul 05, 2018 plica syndrome of the knee is a constellation of signs and symptoms that occur secondary to injury or overuse. Its main function is to create synovial fluid which helps nourish and lubricate your joint. Nov 21, 2017 plica knee syndrome can be painful but there are therapies and exercises that can help. It is usually associated with palpation on the medial patellofemoral joint. However, few reports regarding diagnosis based on detailed physical examination and magnetic resonance imaging mri findings are available. This can cause the whole knee to be painful and hard to move.
Jun 15, 2018 as a result, there may be a causeeffect relationship between the synovial plica and development of chondromalacia patella. Thickened synovial plicae in the radiocapitellar joint have been reported as a cause of lateral elbow pain. Synovial plicae are seen best on t2weighted mri, appearing as bands of low signal intensity within the high signal intensity joint. Between 2002 and 2006, 63 patients with pathological synovial plicae of the knee were studied. In most patients, this gliding motion of the plica will occur without any symptoms, because of the high viscosity of the native synovial fluid of the knee. A plica synovialis is a membranous fold or ridge found in the synovial lining of a joint. The synovial membrane of the knee is the inner aspect of the knee capsule, which produces synovial fluid to aid in the lubrication of the knee joint. The most commonly found folds were the plica synovialis infrapatellaris 69%. Ta a ridge or projection of the synovial membrane of a joint extending toward or between the two articular surfaces.
Synovial plica, sometimes referred to as patella plica, is an injury to the fold in the sheath that surrounds and produces the synovial fluid that lubricates the knee. Three such folds are found with regularity in the human knee, but most. Therapeutic exercise and modalities may also be used to treat the plica. One of the four folds, the medial plica, sometimes gets irritated from an injury or if you overuse your knee. The synovial folds found along the medial border of the knee cap are known as synovial plica. Anatomy and mr imaging appearances of synovial plicae of the knee. Arthroscopic resection of medial plica of the knee in young adults. As a result of overuse or injury, plica can become inflamed or irritated due to friction. First, the care provider may prescribe a nonsteroidal antiinflammatory medication. Identifying the presence of a synovial plica is not easy because it can be so easily ascribed to some other pathology. Oct 30, 2017 however, in one study from 2006, 95 percent of people undergoing arthroscopic surgery had some remnant of the synovial plicae. It is a fold of synovium which originates from a narrow base in the intercondylar notch, extends distally in front of the anterior cruciate ligament acl and inserts into the inferior of the infrapatellar fat pad.
Jun 07, 2011 when your kneecap glides back and forth, it can pinch the plica, causing pain. A plica is a fold of synovial tissue that represents remnant of the synovial membrane from the embryologic develop ment of the knee. Pdf suprapatellar plica classification and suprapatellar. This is a condition relating to irritation, enlargement, or inflammation of the plica in the knee. Synovial plicae are seen commonly on knee mr examination, but they usually are asymptomatic unless they are thickened and. Mri is an established technique for evaluating the anatomy of the knee, and it is a valuable tool for. The synovial folds can become thickened and sometimes inflamed. However, there are key characteristics that show up when a plica is present. Knee synovial membrane radiology reference article. There is a syndrome that is caused by the irritation and resultant inflammatory reaction of the relic of the synovial plica of the knee that is known as pathological synovial plica syndrome. Synovial plica syndrome explained credihealth blog. Bilateral lateral synovial plicae presentation, an uncommon condition.
Plica syndrome of the knee is a constellation of signs and symptoms that occur secondary to injury or overuse. Further impingement of this now thickened plica can cause predictable and repro ducible pain with direct pressure or when tension is placed on the sensitive synovial tissue. Asymptomatic synovial plicae may be found normally within the knee. The synovial plicae in the knee joint article pdf available in saudi medical journal 2712.
Mar 10, 2017 medial synovial plicae are embryological structures that form within the knee. Aug 29, 2018 the synovial membrane secretes synovial fluid into the joint which helps in lubrication of the joints, shock absorption, and nutrient and waste transportation. A plica is a band of thick, fibrotic tissue that extends from the synovial. The two latter terms 16 are likely to be a reminder of hughstons ideas and may cause confusion with the medial plica. Treatment of pathological synovial plicae of the knee scielo. Plica is a membrane in the lining of the kneejoint or continuation of the protective synovial capsule that divides the knee into separate sections during fetal development. Synovial plica are folds within the fibrous membrane that eventually dissolve into the joint capsule of the knee. Plica syndrome causes knee pain and is basically when a part of the synovial capsule of the knee becomes irritated, enlarged, or inflamed. A plica is a thin wall of synovial joint tissue that is an extension of the synovial capsule of the knee. The synovial plica is directly implicated as part of the knee joint and is indirectly attached to the quadriceps mus culature as the position of the plica is dynamicallycontrolled during knee. Synovial plicae are folds of synovium, thought to represent embryologic remnants.
Depending on how much the pdf is damaged we will be able to recover it partially or completely. The synovial plica of the knee is formed during the. There are four plica in the knee including the suprapatellar, infrapatellar, medial patellar and lateral patellar. This dysfunction can be due to overuse, injury, or abnormal mechanics. They are not consistently present, but they are normal anatomic structures found in the knee. In most patients, this gliding motion of the plica will occur without any symptoms, because of the high viscosity of the native synovial. This injury to the knee can cause the plica, and the synovial tissue around the plica, to. This crepitation or catching can occur with patients while going up or down stairs, squatting and bending, and other types of activities.
Anatomy and mr imaging appearances of synovial plicae of. Rearrange individual pages or entire files in the desired order. Plica syndrome plica syndrome classification and external resources icd9 727. When your kneecap glides back and forth, it can pinch the plica, causing pain. The diagnosis can sometimes be difficult, but if this is the source of your knee pain, it can be easily treated. Hypertrophic and fibrotic plicae are found in 3% of knee arthroscopies and will be the only finding in patients with plica syndrome, most commonly. Synovial plica plica syndrome is a well established cause of anterior knee pain in some patients. Aetiology the condition is caused by catching of the synovial folds within the knee during bending. Synovial plicae in the knee are common folds of synovium that can be seen on knee mr images as bands of low signal intensity within the highsignalintensity joint fluid. As a result, there may be a causeeffect relationship between the synovial plica and development of chondromalacia patella.
Knee plica and knee pain everything you need to know. Bilateral symptomatic lateral parapatellar synovial plica. Plica syndrome happens when one of your plica is inflamed, usually. Injury to the plica can also happen suddenly, such as when the knee is struck in the area around the medial plica. Suprapatellar plica classification and suprapatellar plica syndrome.
Arthroscopic classification of suprapatellar plica and. The development of synovial plicae in human knee joints. Synovial plicae are normal anatomical structures of the knee that may become symptomatic. Bilateral bucket handle medial plica in an adolescent.
Apr 19, 2014 synovial plica syndrome or simply plica syndrome. Inflamed plica is a fold in the lining of the knee joint. Medial synovial plica irritation anterior knee pain. They are normal anatomical structures found within the joint capsule of the knee, appearing as thin, soft, and flexible structures that move with the knee during flexion and extension. Medial synovial plica irritation clinical presentation. Your knee joint is surrounded by a fluidfilled capsule called the synovial membrane. The important findings of this report showed that extremely rare lateral parapatellar synovial plica developed simultaneously in both knees by one trauma, and which occurred during the adolescent growth period. Synovial plica synovial plica are folds of embryonic remnants of synovial membrane which, in the foetus, divide knee into three compartments. Synovial problems removal of painful plica the synovial membrane is found in joints like your knee and shoulder. Plicae are a common cause of anterior knee pain associated with episodic clicking in the knee. It is characterized by supra and midpatellar pain with knee extension as well as the presence of audible cracking noises with knee flexion and extension. A plica is a fold in the thin tissue that lines your knee joint. The following is the supplementary data to this article.
It is a congenital disorder in which the thin wall of fibrous tissue extends from the synovial. Athletes at risk for symptomatic medial plica include bicyclists, runners, rowers, and others where direct blows to the medial. Treatment for plica syndrome should focus on decreasing the inflammation of the synovial capsule. In all patients, the medial synovial plica will glide over the anteromedial aspect of the medial femoral condyle with flexion and extension of the knee. Prominent synovial plicae in radiocapitellar joints as a. Pdf the synovial plicae in the knee joint researchgate. Asymptomatic and symptomatic synovial plicae of the knee. Plica synovialis definition of plica synovialis by medical.
How to combine pdf files into one document lifewire. Suprapatellar synovial plica with complete septum is a relatively rare disease, but it sometimes causes anterior knee pain, suprapatellar swelling, and flexion disorder in young people. Before you combine the files into one pdf file, use merge pdf to draganddrop pages to reorder or to delete them as you like. Only 1 patient had same type of plica in both the type of su prapatellar plica and medial synovial plica. This thin membrane surrounds the inner lining of your joint and may have folds and fringes. Started in 1995, this collection now contains 6767 interlinked topic pages divided into a tree of 31 specialty books and 732 chapters. For patients who have medial plica irritation as their main diagnosis without any underlying knee pathology contributing to their plica irritation, there is a very good chance that their symptoms will improve with a guided rehabilitation program 1, 12. The mediopatellar plica originates from the medial wall of the knee joint, runs obliquely downward, and inserts into the synovium covering the infrapatellar fat pad. Plica syndrome is an interesting problem that occurs when an otherwise normal structure in the knee becomes a source of knee pain due to injury or overuse.
Nov 27, 2007 the main treatment regimen for medial plica irritation is nonoperative. This injury results in irritation or inflammation of the fold, which is found along the inside border of the knee cap. A nonsteroidal antiinflammatory drug nsaid is often used in conjunction with therapeutic exercise and modalities. Plica syndrome is an irritation of the synovial membrane in the knee.
Aug 24, 2009 to analyze the incidence, clinical significance, and clinical manifestations of pathological synovial plicae of the knee. In some instances, there is a lateral plica, but it is more common to find the lateral transverse arcuate fold in place of the lateral plica. We prefer to include the synovial folds of the elbow with the general term of synovi al fold of the radiohumeral joint 6, 9, 10 be elbow synovial fold syndrome luis cerezal1 mario rodriguezsammartino2 ana canga3 carlos capiel 4 javier arnaiz3 antonio cruz5 alejandro rolon6. Your plica can catch during knee straightening and bending, when you experience blunt trauma, have altered knee motions, or. Asymptomatic and symptomatic synovial plicae of the knee joint. Article information, pdf download for lateral synovial plica syndrome open epub for. The causes and diagnostic approach to knee pain in the young athlete and adults are discuss it seems to us that you have your javascript disabled on your browser. Iontophoresis and phonophoresis have been utilized successfully against inflammation of the plica and synovial capsule. Occurs in 50% of the patients due to blunt trauma to the knee. Three such folds are found with regularity in the human knee.
Patients often have concurrent patellar subluxation or apprehension, and this should be. Synovial plica syndrome is known to cause knee symptoms. It was statis tically unknown whether suprapatellar plica and medial synovial plica were the same because there were few numbers. This minimally invasive procedure is performed by your surgeon using a small incision and the insertion of a scope and a specialized surgical instrument to remove the damaged synovial tissue and plica. Pain usually occurs when the synovial capsule becomes inflamed. Feb 27, 2015 medial synovial plica test for the patellofemoral region. Synovial plica syndrome sps occurs in the knee, when an.
The most commonly encountered plicae of the knee in descending order are the infrapatellar plica ligamentum mucosum fig 1, the suprapatellar plica, and the mediopatellar plica 1,2. Since the medial synovial plica does have an attachment to the genu articularis muscle, and also an indirect. Exploring synovial plica of the knee academy of clinical. They are common, present in 90% of arthroscopies 3 they have been implicated in anterior knee pain and possibly in chondromalacia patellae although their role remains controversial 1,3. The mediopatellar plica is also referred to as the medial plica, plica synovialis patellaris, iino band, plica alaris, synovial shelf, or patellar meniscus. It is also reflected on to the articular margins of the femur, tibia and patella. Four plica synovial folds are found in the knee, but only one seems to cause trouble. All uploads and downloads are deemed secure and files are permanently deleted from the smallpdf servers within an hour. Plica syndrome or synovial plica syndrome inflames the knee. Synovitis, lipoma arborescence and rice bodies austin. Synovial plica irritationsymptomspreventiontreatmentpt. The suprapatellar plica is a synovial fold present in the suprapatellar pouch of the knee joint in approximately 20% of the population. The synovial fluid is produced by the synovial sheath which may also become inflamed.
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