Journal of Pediatric Health CarePatellofemoral Pain Syndrome in Adolescents: Continuing Education for the Primary Care Provider

This continuing education article provides comprehensive guidance for primary care providers on managing patellofemoral pain syndrome (PFPS) in adolescents, emphasizing evidence-based diagnosis and treatment approaches. The content integrates anatomical understanding with practical implementation strategies for the 28.9% prevalence condition affecting adolescent patients.

⚕️ Key Clinical Considerations ⚕️

• Female predominance: Adolescent females show 4.6 cases per 1,000 versus 2.3 cases per 1,000 in males, with peak incidence at age 13 years across both genders.
• Diagnosis of exclusion: PFPS requires ruling out meniscus injuries, septic arthritis, and Osgood-Schlatter disease through targeted physical examination and clinical assessment protocols.
• Vitamin D correlation: 71% of PFPS patients demonstrate insufficient or deficient vitamin D levels, supporting supplementation as both preventive and therapeutic intervention.
• Physical therapy gold standard: Exercise therapy with PT demonstrates superior long-term outcomes compared to pharmaceutical interventions or surgical referrals for adolescent PFPS management.
• Psychological component: Pain catastrophizing, kinesiophobia, and depression significantly correlate with functional limitations, requiring integrated mental health approaches alongside physical treatment.

🎯 Clinical Practice Impact 🎯

• Patient Communication: Educate families that PFPS affects nearly 30% of adolescents and emphasize non-traumatic onset patterns. Address psychological components early, explaining that pain doesn’t always correlate with tissue damage severity.
• Practice Integration: Implement 45-second anterior knee pain provocation test and establish PT referral protocols. Consider vitamin D screening for adolescent athletes presenting with knee pain complaints.
• Risk Management: Recognize red flags including joint effusion, fever, or “catching/giving way” symptoms requiring alternative diagnostic workup. Document exclusion of septic arthritis and meniscal pathology appropriately.
• Action Items: Establish relationships with pediatric physical therapists and sports psychologists. Develop patient education materials addressing overuse injury prevention and healthy recovery practices for adolescent athletes.

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