Medial plica syndrome is an overuse condition caused by irritation or inflammation of the synovial plica, most commonly the medial plica.
Medial plica syndrome is an overuse condition caused by irritation or inflammation of the synovial plica, most commonly the medial plica. Patients often experience clicking, snapping, or a catching sensation during knee movement, with symptoms worsening during repetitive activities such as running, squatting, or climbing stairs. Normal plicae are thin, pliable folds of the synovial lining present in most knees, but pathologic plicae become thickened, fibrotic, and inelastic due to inflammation.
Treatment is typically non-surgical, with surgery reserved for refractory cases, and long-term outcomes are generally favorable. Diagram of the three types of synovial plicae There are four major synovial plicae in the knee : medial patellar, suprapatellar, infrapatellar, and lateral patellar. The medial patellar plica is the most clinically significant, as it can become pathologic and bowstring across the femoral trochlea, leading to impingement between the patella and femur during knee flexion.
The other plicae—suprapatellar, infrapatellar, and lateral patellar—are typically less symptomatic but can also be involved in knee discomfort in certain cases. An anatomical depiction of the various manifestations of plicae in the knee joint. An anterior view of a bent knee joint is depicted.
The bottoms of the femoral condyles are visible, as would be in a bent knee. The patella is rolled away upwards, exposing the sesamoid bone's underside. Four plicae are depicted here, however, any variation of these plicae may exist in a live knee.
This image depicts the approximate locations that each of the plicae may exist in a live knee. Each plicae is represented here with a unique color; the mediopatellar plicae is depicted in blue, the suprapatellar plica is depicted in magenta, the lateral plica is depicted in red, and the infrapatellar plica is depicted in green. The anterior cruciate ligament is also visible.
If you are experiencing symptoms that may be related to medial plica syndrome, it is important to see a sports medicine physician. Early evaluation and treatment typically lead to better outcomes. Do not ignore pain or symptoms that are limiting your activity.
*This article is for educational purposes only and does not substitute for professional medical advice. Always consult a qualified healthcare provider.*
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