CAUSES: Mechanical overload of the patellofemoral joint. a) Malcongruence - patellofemoral surfaces b) Malalignment -- extensor mechanism - weakness of vastus medialis ingle injury -- damage to aicular surface CLINICAL FEATURES * Introspective teenage girl or athletic young adult * Flat foot / Knock kneed athletes * Spontaneous Pain in front of knee/ beneath the knew cap * Maybe h/o recurrent displacements/injury * Aggravated by activity/climbing down stairs/standing after prolonged sitting with knees flexed * Both knees * Swelling-give way-catching(not true locking) * Grating/grinding sensation when knee is extended Conservative Rx * Reassurance * Ice Application * Physiotherapy * Avoid stressful activities * Stretching and strengthening medial quadriceps in 15 mins 4 times/day -- Quad sets (bicycling, pool running, swimming flutter kick * Aspirin / Ibuprofen / Naproxen * Suppo for a valgus foot STEROIDS BEST AVOIDED ref : maheswari 9th ed