The medial suprapatella plica is a common source of knee pain. It is a normal fold of the joint lining which can become irritated when there are other pathologies of the knee or it can become fibrotic after injury or surgery. Thus, assessment of this as a source of pain is helpful to differentiate if medial knee pain is solely due to plical irritation, or if there is also joint line pain, and the treatment modalities and workup may be different based on the findings of this physical exam.
Palpation of the medial suprapatella plica is performed with the knee in full extension. The tissues forming the plica are located midway between the medial border of the patella and the adductor tubercle. The plica is then rolled under ones fingers to feel for signs of pain or irritation. It is important to work with the patient to determine if this is solely irritated from ones exam or if it duplicates the source of their pain. Sometimes palpating the contralateral normal knees plica can help to differentiate this during this portion of the physical exam.
