Sonographic assessment of patellofemoral pain syndrome: Diagnostic utility and correlation with functional impairment

Aims: Patellofemoral pain syndrome is a prevalent cause of anterior knee pain, often challenging to diagnose due to its multifactorial aetiology. This study investigates the diagnostic utility of musculoskeletal ultrasonography in patellofemoral pain syndrome and its correlation with pain and functional impairment. Methods: This case-control study enrolled 32 participants (16 patellofemoral pain syndrome, 16 controls). Sonographic measurements of patellar and quadriceps tendons, lateral retinaculum, joint effusion, and trochlear angle were taken. Pain intensity and knee function were assessed using the Visual Analogue Scale and Kujala Anterior Knee Pain Scale . Diagnostic accuracy was evaluated using receiver operating characteristic curve analysis. Results: Significant differences in patellar tendon, quadriceps tendon, and lateral retinaculum thicknesses were observed between patellofemoral pain syndrome and control groups. Modified cut-offs adjusted for height improved diagnostic accuracy, with the combination of two out of three criteria yielding 96% sensitivity and 73% specificity. No significant correlation was found between Visual Analogue Scale and sonographic findings, but Kujala scores correlated significantly with tendon and retinaculum thicknesses. Conclusion: Musculoskeletal ultrasonography offers a non-invasive, reliable diagnostic modality for patellofemoral pain syndrome. A two-out-of-three criteria approach enhances diagnostic precision, suggesting potential utility in clinical and screening settings.