For the diagnosis of a plica syndrome one first of all tries to localize the pain exactly or to diagnose a thickening in the area of the kneecap. Often one can feel the rubbing of the plica inside of the knee joint when it is moved. Typical are the pains when tensing the musculature of the thigh while the examiner presses the kneecap against the coat bearing (positive “Zohlenzeichen”). This test, however, can be also positive in case of a retropatella cartilage damage. 50% of all patients generally consider it as very uncomfortable when this test is performed on them.
An MRT examination can also be helpful for the diagnosis, though it does not always provide clear results, especially if an outpouring in the knee joint exists at the time of the examination. In case of some patients the final evidence for a plica syndrome can only be produced within the framework of an arthroscopy (endoscopic measuring).
The arthroscopy of this 16 year old top athlete with permanent pains next to and behind the kneecap showed this distinct plica mediopatellaris. After the removal the patient was nearly painless and could start at an international pole-vaulting competition 12 weeks later.