Diagnostic test accuracy of clinical and radiological assessments for medial patella plica syndrome

The Medial Patellar Plica (MPP) is a normal thin, flexible, elastic fold of the synovial tissue, found on the medial aspect of the patello-femoral joint. The MPP is most commonly injured either by direct trauma or by repetitive activities. 

This systematic review aimed to evaluate the diagnostic accuracy of MRI, US scan and a clinical test for the MPP syndrome (the gold standard was surgery). Seven articles were included. Results show the following: 

- The best clinical test is the "MPP test", with a high sensitivity (0.90) and specificity (0.89). It is performed by pressing on the inferomedial portion of the patella while passively bringing the knee from extension to 90° flexion. The test is positive when symptoms are reproduced in extension and absent in flexion. 
- US scan shows comparable sensitivity and specificity to the MPP test. 
- Meta-analysis showed that MRI was inferior to US and to the MPP test. 

Although some studies had methodological limitations, the reviewers conclude that clinical assessment with the "MPP test" can provide accurate results in the diagnosis of medial patellar plica syndrome. > From: Stubbings et al., Knee 21 (2014) 486–490. All rights reserved to Elsevier B.V.

Visit the Pubmed summary for more information or your article access. Want to know more about this subject? Click here to read an interesting case study or watch a video of the arthroscopic removal of the medial plica below: