Dawaa Reference

chronic

Patella disorder

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources3 sources

ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class LD69 - condition scope only, no dose · No dose - referral pathway, no medicine given in primary care · Patellofemoral Syndrome - StatPearls - NCBI Bookshelf - https://www.ncbi.nlm.nih.gov/books/NBK557657/

Verified against2 documents
  • No dose - referral pathway, no medicine given in primary care
  • Patella disorder - disease-level clinical article (patella-disorder-full.txt)

Verified date2026-08

Presentation reference

Is it this?

Reference only, to read alongside your own examination.

Symptoms — what the patient reports (2)

  • A twisting knee injury with a felt pop, swelling, and a sense of the knee giving way suggests dislocation [joint instability]
  • Chronic cases bring anteromedial pain, clicking, and catching that worsens with kneeling and deep flexion [locking]

Signs — what you find (4)

  • Acute dislocation typically produces a knee effusion or hemarthrosis, rarely seen in chronic cases [hemarthrosis]
  • Tenderness is most pronounced at the medial edge of the kneecap on palpation
  • A positive J sign, the kneecap drifting laterally as the knee straightens, suggests instability
  • Guarding when the kneecap is pushed sideways with the knee bent 20 to 30 degrees is a positive apprehension sign [guarding]

Tests (4)

  • AP, lateral, and sunrise knee radiographs look for fracture, loose bodies, and patella alta
  • An Insall-Salvati ratio over 1.2 signals patella alta, and under 0.8 signals patella baja
  • A CT-measured TT-TG distance above 20mm is considered abnormal and supports instability
  • MRI after a full dislocation classically shows bruising of the lateral femoral condyle and medial kneecap, plus MPFL tearing

If not this — what else fits (3)

  • ACL and MCL injuries are also considered on the differential for an acute knee injury with swelling
  • Meniscal injury and patellofemoral syndrome are further differentials for anterior knee pain
  • Medial synovial plica and chondromalacia are also considered for this pattern of knee pain

SourceStatPearls "Patella Dislocation" - disease-level clinical article

Presentation findings are traced to the source above.

1

NO DRUG THERAPY IN PRIMARY CARE (REFERRAL & ADVICE)

1st line
Adult dose and duration

Umbrella term for kneecap disorders including recurrent patellar instability; the GP manages pain and refers for physiotherapy or surgical stabilisation when instability recurs. - Refer, with advice

Paediatric dose

Children follow the same pathway: recognise and refer. No primary-care medicine is implied.

Dose source

No dose - referral pathway, no medicine given in primary care

Why

Umbrella term for kneecap disorders including recurrent patellar instability; the GP manages pain and refers for physiotherapy or surgical stabilisation when instability recurs.

Cautions
  • Recurrent frank dislocation, large knee effusion, locking suggesting a loose body.
  • No medicine is prescribed for this in primary care - this entry is for recognition and referral. Anything given is decided by the service it is referred to.
  • RED FLAG - First-time patellar dislocation accompanied by an osteochondral fracture or loose body requires prompt surgical evaluation/management.
  • RED FLAG - Failure to improve with conservative management in the presence of predisposing anatomical factors warrants surgical referral.

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.