Patellofemoral pain syndrome has been suggested as a diagnosis of exclusion reserved for patients with anterior knee pain without one of the conditions described above. Causes of this variety of anterior knee pain are somewhat controversial. Fulkerson points out that there are six main tissues to consider when looking for the etiology of patellofemoral pain. These include subchondral bone, synovium, retinaculum, skin, muscle, and nerve. He believes that the most common causes of pain from an orthopedic standpoint are overuse, patel-lofemoral malalignment, and trauma .
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