# Chondromalacia patellae (retropatellar) - Category: acute - Review status: reviewed (every claim checked against a document named on this page) - Sources: Ibuprofen 100 mg/5 ml SmPC section 4.2 (eMC product 4560) · MSF Essential Drugs 2024 - paracetamol (oral) · Habusta SF, Coffey R, Ponnarasu S, et al. Chondromalacia Patella. [Updated 2023 Apr 22]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Bookshelf ID NBK459195; PMID 29083563. - Verified date: 2026-08 ## Verified against - MSF Essential Drugs 2024 - paracetamol (oral) - SmPC section 4.2, https://www.medicines.org.uk/emc/product/4560/smpc ## Treatment metadata - Paracetamol — 500 mg — oral.solid - Ibuprofen — 400 mg — oral.solid ## Complete treatment card ```text CHONDROMALACIA PATELLAE (RETROPATELLAR) Sources: Ibuprofen 100 mg/5 ml SmPC section 4.2 (eMC product 4560) · MSF Essential Drugs 2024 - paracetamol (oral) · Habusta SF, Coffey R, Ponnarasu S, et al. Chondromalacia Patella. [Updated 2023 Apr 22]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Bookshelf ID NBK459195; PMID 29083563. Review status: REVIEWED against 2 sources listed above (2026-08) IS IT THIS? - reference only, to read alongside your own examination SYMPTOMS - what the patient reports (4) - Pain in front of the knee is the leading complaint, often a vague, slow-onset ache behind or in front of the kneecap [joint pain · knee pain] - Stairs, squatting, kneeling, running, or sitting for a long time all make the pain worse - sometimes called theatre pain - Swelling, thigh-muscle wasting, and a grinding sensation behind the kneecap are all reported but none is specific to this diagnosis [crepitus · muscle wasting] - History-taking should cover past injury, other medical conditions, joint instability, and foot or ankle pain or dysfunction [foot pain · joint instability] SIGNS - what you find (4) - Exam should look at thigh muscle bulk for wasting, and the alignment of the foot and ankle [muscle wasting] - Kneecap-specific exam covers pain, swelling, quad strength, how freely the kneecap moves, and grinding - Watch for signs the kneecap is tracking off-center - increased thigh-bone rotation, increased shin-bone twist, the kneecap slipping laterally, reduced inward glide, and a positive apprehension test - The Clark test - pressing the kneecap into the groove while the patient tightens the thigh muscle - specifically checks for grinding pain from this condition TESTS (8) - Plain x-rays miss early disease but in advanced stages can show cartilage breakdown, cysts, cartilage loss, or narrowed joint space - X-rays can also point to an underlying cause such as a shallow groove, a high- or low-riding kneecap, or lateral tilt - CT scanning can measure a specific alignment distance (TT-TG) and pick up rotational deformity of the leg - MRI is the preferred test for assessing the cartilage, with damaged cartilage showing up bright on T2 sequences - MRI is noninvasive, more consistent, and picks up more disease than arthroscopy does - On MRI, affected patients tend to show a shallower groove, a smaller tilt angle for the kneecap, and a wider sulcus angle - Thicker fat under the skin around the knee on MRI tracks with a worse disease grade, and is more pronounced in women - Arthroscopy is the single best way to see and size the cartilage damage directly, but its invasiveness makes noninvasive tests the preferred first step IF NOT THIS - what else fits (2) - Joint and cartilage mimics include an osteochondral fragment behind the kneecap, patellofemoral arthritis, patellofemoral pain syndrome, lateral compression syndrome, and plica syndrome - Soft-tissue and alignment mimics include tendinopathy of the quad or patellar tendon, a saphenous or postoperative neuroma, inflamed fat pad (Hoffa disease), a high- or low-riding or unstable kneecap, or a bipartite patella Source StatPearls "Chondromalacia Patella" - disease-level clinical article Status traced to the source above 1. PARACETAMOL [1st line] Adult 1 g three or four times daily, maximum 4 g in 24 hours - As needed for pain or fever Peds 15 mg/kg/dose [child max 500 mg] (Child 1 month and over: 15 mg/kg per dose, 3 or 4 times daily, maximum 60 mg/kg daily. Child under 1 month: 10 mg/kg per dose, 3 or 4 times daily, maximum 40 mg/kg daily. MSF's own weight table gives one 500 mg tablet three times daily from 30 kg to under 50 kg, so 500 mg is the per-dose ceiling; the 60 mg/kg daily total still applies.) 3kg -> 45 mg/dose 4kg -> 60 mg/dose 5kg -> 75 mg/dose 6kg -> 90 mg/dose 7kg -> 105 mg/dose 8kg -> 120 mg/dose 9kg -> 135 mg/dose 10kg -> 150 mg/dose 11kg -> 165 mg/dose 12kg -> 180 mg/dose 13kg -> 195 mg/dose 14kg -> 210 mg/dose 15kg -> 225 mg/dose 16kg -> 240 mg/dose 17kg -> 255 mg/dose 18kg -> 270 mg/dose 19kg -> 285 mg/dose 20kg -> 300 mg/dose 21kg -> 315 mg/dose 22kg -> 330 mg/dose 23kg -> 345 mg/dose 24kg -> 360 mg/dose 25kg -> 375 mg/dose 26kg -> 390 mg/dose 27kg -> 405 mg/dose 28kg -> 420 mg/dose 29kg -> 435 mg/dose 30kg -> 450 mg/dose 31kg -> 465 mg/dose 32kg -> 480 mg/dose 33kg -> 495 mg/dose 34kg -> 500 mg/dose (capped) 35kg -> 500 mg/dose (capped) 36kg -> 500 mg/dose (capped) 37kg -> 500 mg/dose (capped) 38kg -> 500 mg/dose (capped) 39kg -> 500 mg/dose (capped) 40kg -> 500 mg/dose (capped) 41kg -> 500 mg/dose (capped) 42kg -> 500 mg/dose (capped) 43kg -> 500 mg/dose (capped) 44kg -> 500 mg/dose (capped) 45kg -> 500 mg/dose (capped) 46kg -> 500 mg/dose (capped) 47kg -> 500 mg/dose (capped) 48kg -> 500 mg/dose (capped) 49kg -> 500 mg/dose (capped) 50kg -> 500 mg/dose (capped) Source MSF Essential Drugs 2024 - paracetamol (oral) Why Standard analgesic dosing regardless of the cause of the knee pain. Caution Persistent locking or a large effusion suggesting a different intra-articular problem. Simple first-line analgesic for anterior knee pain. Do not exceed 4 g in 24 hours. Persistent locking or a large effusion suggests a different intra-articular problem and needs referral. Administer with caution to patients with hepatic impairment. Egypt FEBRIMOL 500 MG 20 TAB. PHARCO 3.50 EGP (0.17/unit) CETAMOL 500 MG 20 TABS. MEMPHIS 8.00 EGP (0.40/unit) PARACETAMOL-MUP 500MG B.P. 20 TABS. MUP 13.00 EGP (0.65/unit) CETAL 500 MG 20 TABS. EIPICO 24.00 EGP (1.20/unit) ARKADOLOW 500 MG 30 F.C. TABS. UTOPIA 42.00 EGP (1.40/unit) PARAMOL 500MG 20 TAB. MISR 38.00 EGP (1.90/unit) ADOL 500MG 24 CAPLETS JULPHAR 32.00 EGP AUGICETAMIDE 500 MG 20 SACHETS AUG PHARMA 50.00 EGP FEBRIMOL ORAL DROPS 20 ML PHARCO 4.00 EGP -> ? strength differs, ? different route - not oral solid THERA-LO 3.2G/100ML ORAL SUSP. 100 ML PHAROPHARMA 5.00 EGP -> ? strength differs, ? different route - not oral solid 2. IBUPROFEN [2nd line] Adult 200-400 mg PO Q6-8H PRN, max 1200 mg/day. Peds Age 3m+: 20-30 mg/kg/day divided Q6-8H PRN. (Dosed by age bands on liquid suspension labels). Source SmPC section 4.2, https://www.medicines.org.uk/emc/product/4560/smpc Why Standard NSAID analgesic dose for patellofemoral pain; the much higher anti-inflammatory pericarditis regimen is unnecessary for this non-inflammatory overuse condition. Caution Use alongside quadriceps-strengthening physiotherapy and activity modification, which remain the mainstay of treatment. Avoid in NSAID-exacerbated asthma, active peptic ulcer disease, or renal impairment. Take with or after food. Egypt DAJUANOFEN 400 MG 20 F.C. TABS. COPAD PHARMA 5.00 EGP (0.25/unit) FLABU 400MG 10 F.C.TAB. DELTA PHARMA 3.75 EGP (0.38/unit) NOVA-PROFEN 400MG 30 F.C. TABLETS SANOFI 12.75 EGP (0.42/unit) IBUPROFEN 400 MG 10 TAB. SEDICO 6.00 EGP (0.60/unit) MAFO 400 MG 30 F.C.TABS EIPICO 42.00 EGP (1.40/unit) BRUFEN 400 MG 30 TABS. KAHIRA > ABBO... 78.00 EGP (2.60/unit) PROFUSOL 400MG 20 S.G CAPS. EUROPEAN EGYP... 31.00 EGP ANALGIPROF 400 MG 25 SACHETS EVA PHARMA 37.50 EGP NOVA-PROFEN 100MG/5ML ORAL SUSP. 100ML SANOFI 2.25 EGP -> ? strength differs, ? different route - not oral solid BRUFEMOL-N SUSP. 60 ML ARAB DRUG COM... 4.50 EGP -> ? strength differs, ? different route - not oral solid Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy. ``` --- Dawaa Reference is a reference for prescribers, not a medical device, and does not replace clinical judgement. [Privacy policy](/privacy)