chapter 7: nonarthritic anterior knee pain
Although very uncommon, hemangiomata can occur in skeletal muscle and have been reported in many locations around the body. We have found hemangiomata in the distal quadriceps muscle (see Fig. 4.31) in two patients with anterior knee pain. If careful examination of the patient with anterior knee pain demonstrates muscle tenderness, one should consider the possibility of a hemangioma. Simple excision will be curative.
Cox (31) has pointed out the occurrence of stress related patellofemoral pain in runners. Gymnasts (32) have also described overuse problems in the anterior knee area. Irritation of the iliotibial band as it moves across the lateral femoral condyle is a common cause of such pain in active young athletes. If there is mild patellar malalignment, retinacular problems as previously described may occur and result in "overuse" pain. Devereaux et al (33) have pointed out that the vastus medialis insertion may also be a cause of overuse pain in athletes. Most of the anterior knee overuse problems in athletes can be localized by careful clinical evaluation (34).
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