Snapshot A 27-year-old female presents with knee pain. Her pain worsens when she is running downhill or climbing up the stairs. She describes the pain as "achy" and being behind the knee. When sitting for long periods of time, she reports her knees feeling stiff. She denies any recent history of trauma and has never had surgery. She has tried multiple over-the-counter analgesics but were not effective. She is a high school teacher and an avid runner who is preparing for a marathon. A full knee examination is performed. Introduction Overuse of patellofemoral area involving the knee and the retinaculum login to view 2 more bullets Epidemiology More common in women Commonly seen in runners or cyclists Etiology Overuse (most common) login to view 1 more bullet May be secondary to patellofemoral joint overload Presentation Physical symptoms login to view 2 more bullets STUDIES Patellofemoral compression test login to view 1 more bullet Differential Chondromalacia Patellofemoral osteoarthritis Iliotibial band syndrome Prepatellar bursitis DIAGNOSIS Clinical diagnosis login to view 1 more bullet Treatment Physiotherapy (first-line) of the quadriceps login to view 3 more bullets Pain management login to view 3 more bullets Complications May have to limit sports activities Prognosis Favorable prognosis