5-Minute Pediatric Consult
Knee Pain, Anterior/Patellofemoral Malalignment Syndrome
BASICS
DESCRIPTION
Characterized by pain or discomfort around the anterior knee and/or behind the patella, worsened by weight-bearing activity during which the knee is flexed
EPIDEMIOLOGY
Patellofemoral pain is quite common, reported in approximately 25% of adolescents.
PATHOPHYSIOLOGY
- Anatomic factors such as femoral anteversion, genu valgum, and pes planus or pronation may predispose individuals to anterior knee pain—this combination is referred to as “miserable malalignment.”
- Weak hip abductors and quadriceps muscles as well as tight hamstrings, iliotibial band, Achilles tendon, and quadriceps can lead to dynamic valgus stress, which increases forces across the patellofemoral joint.
- Chondromalacia: Patellar articular cartilage pathologic change, from softening to disruption, can be caused by microtrauma from abnormal mechanics, patellar malpositioning, or abnormal shape.
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Citation
Cabana, Michael D., editor. "Knee Pain, Anterior/Patellofemoral Malalignment Syndrome." 5-Minute Pediatric Consult, 9th ed., Wolters Kluwer, 2025. Pediatrics Central, peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/618160/all/Knee_Pain__Anterior_Patellofemoral_Malalignment_Syndrome.
Knee Pain, Anterior/Patellofemoral Malalignment Syndrome. In: Cabana MDM, ed. 5-Minute Pediatric Consult. Wolters Kluwer; 2025. https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/618160/all/Knee_Pain__Anterior_Patellofemoral_Malalignment_Syndrome. Accessed July 12, 2026.
Knee Pain, Anterior/Patellofemoral Malalignment Syndrome. (2025). In Cabana, M. D. (Ed.), 5-Minute Pediatric Consult (9th ed.). Wolters Kluwer. https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/618160/all/Knee_Pain__Anterior_Patellofemoral_Malalignment_Syndrome
Knee Pain, Anterior/Patellofemoral Malalignment Syndrome [Internet]. In: Cabana MDM, ed. 5-Minute Pediatric Consult. Wolters Kluwer; 2025. [cited 2026 July 12]. Available from: https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/618160/all/Knee_Pain__Anterior_Patellofemoral_Malalignment_Syndrome.
* Article titles in AMA citation format should be in sentence-case
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T1 - Knee Pain, Anterior/Patellofemoral Malalignment Syndrome
ID - 618160
ED - Cabana,Michael D,
BT - 5-Minute Pediatric Consult
UR - https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/618160/all/Knee_Pain__Anterior_Patellofemoral_Malalignment_Syndrome
PB - Wolters Kluwer
ET - 9
DB - Pediatrics Central
DP - Unbound Medicine
ER -
