Arthrography (plica views). A noninvasive method for diagnosis and prognosis of plica syndrome.

In 45 patients with chronic knee problems arthrograms of the knee were obtained with emphasis on plica views. Thirty arthrograms showed radiographic evidence of plica syndrome. Three patients had thin bands in the proximal part of the suprapatellar pouch. Four patients had infrapatellar plicae. Eighteen patients had suprapatellar plicae, and five had mediopatellar plicae. The cross-table lateral view of the knee in different degrees of flexion is a valuable prognostic method. Five patients with suprapatellar plicae demonstrated excursion of the thick fibrotic band over the anteromedial femoral condyle during arthrography with the knee in different degrees of flexion. These patients did not respond to conservative treatment and required surgical excision of the plicae. Cross-table anteroposterior and tangential views with the medial side of the knee facing upward demonstrate impingement of the medial femoral condyle or the medial facet joint of the patella by the fibrotic mediopatellar plica. All patients (5 of 5) with mediopatellar plicae required surgical excision of the plicae.