Initial evaluation of the athlete with anterior knee pain

Anterior knee pain is a common complaint among athletes and active, young individuals. Its causes are broad, but the correct diagnosis can usually be made after a thorough history and physical examination. The history should include a complete investigation of the nature and onset of the athlete's symptoms, past medical history, and the nature of any previous treatment he or she may have received for the problem. The physical examination includes a general lower extremity musculoskeletal examination with determinations of flexibility and limb alignment. The spine and hips are also evaluated to rule out radicular or referred pain to the knee. The knee examination must include assessment of the peripatellar tissues as well as the patellofemoral joint. Although patients often perceive their pain as being poorly localized, the pain source can usually be precisely localized on examination. The information presented here should enable the clinician to make an accurate diagnosis on which to base initial treatment.