#Pica syndrome. free#
It runs downward from the synovium at the anterior side of the femoral metaphysis, to the posterior side of the quadriceps tendon, inserting above the patella.Its free border appears sharp, thin, wavy or crenated in normal conditions. The suprapatellar plica, also referred to as the plica synovialis suprapatellaris, superior plica, supramedial plica, medial suprapatellar plica or septum is a domed, crescent shaped septum that generally lies between the suprapatellar bursa and the tibiofemoral joint of the knee. The plicae in the knee joint can vary in both structure and size they can be fibrous or fatty, longitudinal or crescent-shaped. The last one is rarely seen and, therefore, there is some controversy regarding its existence or its exact nature. In the knee, 4 types of plicae can be distinguished, depending on the anatomical location within the knee joint cavities: suprapatellar, mediopatellar, infrapatellar and lateral plicae. But if a plica has been diagnosed beyond any doubt as being the source of knee pain, it can be treated correctly. The diagnosis might sometimes be difficult because the main symptom of non-specific anterior or antero-medial knee pain can point to various knee disorders. It is an interesting problem, particularly seen in children and adolescents and occurs when an otherwise normal structure in the knee becomes a source of knee pain due to injury or overuse. It refers to an internal derangement of the knee which prevents normal functioning of the knee joint. This can result in a disorder called the plica syndrome. Yet, when repeating the same knee movement too often, such as bending and straightening the knee, or in the case of a trauma to the knee, these plicae can become irritated and inflamed. The elastic nature of synovial plicae allow normal movement of the bones of the tibiofemoral joint, without restriction. It is estimated that plicae are present in about 50% of the population. Various degrees of separation of the cavities are seen in the human knee. The result is that in these individuals plicae can be observed, which represent inward folds of the synovial membrane in the knee joint. Yet, in many individuals the mesenchymal tissue is not fully resorbed and consequently the cavitation of the knee joint remains incomplete. Movement of the foetus in the uterus contributes to this resorption. This tissue usually starts to involute (fold inward) at 8-12 weeks of foetal growth, and is eventually resorbed, leaving a single empty area between the distal femoral and proximal tibial epiphysis: a single knee cavity. This tissue forms membranes which divide the knee into 3 compartments: the medial and lateral tibiofemoral compartments and the suprapatellar bursa. Plicae essentially consist of mesenchymal tissue which is formed in the knee during the embryological phase of development.
A synovial plica is a shelf-like membrane between the synovium of the patella and the tibiofemoral joint.
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