Plica syndrome: Signs, symptoms and treatment of this uncomfortable knee pain

The plica are connective tissue in the knee that exist in all fetuses, but they normally recede to small bands of tissue in adults. They have no significant function, but they can become inflamed and serve as a source of pain in active people.

Signs and symptoms

Typically athletic individuals with plica syndrome complain of pain on the medial side of the knee, just inside of the patella (kneecap). If the tissue is inflamed and swollen, you might notice a snapping sensation as it rubs across the knee with knee motion.

Diagnosis of a painful plica

The diagnosis is often made by exclusion after a sports medicine physician rules out structural problems like meniscal tears. X-rays are usually normal. The doctor might order an MRI to rule out a meniscal tear or other pathology.

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Treatment is usually nonsurgical. Anti-inflammatory medications and ice can help. You can play sports and participate in desired exercise activities if you can tolerate the symptoms. Occasionally the physician might inject cortisone into the plica to try to calm down the inflammation. He might also recommend physical therapy for exercises and possibly ultrasound or other modalities. Occasionally surgery to remove the plica can be performed, although recovery from that surgery can take longer than many patients expect.

In this video, I discuss the common signs and symptoms of an inflamed plica and how you can find out if this could be the cause of your knee pain.

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Location of knee pain from a plica
Pain from a plica is most often felt on the medial side of the knee above the joint line (white arrow).