Not the MCL, medial meniscus or pes anserine, maybe it’s a medial plica.
When patients report medial knee pain, the most common diagnosis that comes to mind is a sprain to the MCL, medial meniscus, sometimes even the pes anserine. One of the less common diagnoses is medial plica syndrome which also presents as localised medial knee pain but often aggravated by different tests. Firstly, what is the medial plica. The medial plica is a synovial structure along the medial wall of the joint that is often aggravated by exercise involving repeated movements of flexion-extension at the knee. It is often reported as a dull pain along the medial border of the patella with pain that increases with activity and upon palpation. There will typically be some swelling at the medial border of the patella with both passive stretching of the quads and fast active flexion or extension, which can be provocative. The gold standard for diagnosis is through an MRI, however often imaging is not required.
Treatment will involve relative rest, anti-inflammatories and a deload from their current level of exercise/physical activity. Once swelling has reduced, regular strengthening of the knee complex will be important.
