Medial Synovial Plica Irritation

A Plica is a fold in the lining of the joint (joint capsule). It’s not known why they exist but they are normal and are considered a reminent embryological structure. There are four in total medial patella, lateral patella, infrapatella  and suprapatella. The most problematic is the medial patella plica.

There are four classifications of medial plica. Although it’s appearance can vary with four different classifications. It may be felt as a tender mild ridge which runs from the inside of the knee to the knee cap.

Plica irritation is often a diagnosis of exclusion and is made via mri scan or arthroscopy.  The cause of irritation is unclear although a poor biomechanics, a direct blow, or overuse is thought to trigger the irritation.

treatment

A similar approach is used as patella femoral pain syndrome. Initially RICE in combination with correcting the underlying biomechanics to attempt to reduce irritation. This may also involve ultrasound, deep friction massage and Cryotherapy. Should this fail a surgical approach would be to arthroscopically excise the plica.