A 17-year-old female with patellofemoral syndrome has mechanical factors contributing to symptoms. Which finding would be most likely?

• A. Lateral patella tracking
• B. Excessive foot supination
• C. Decreased Q angle
• D. Vastus lateralis weakness

Answer: (A)

patellofemoral syndrome commonly comes from how the patella is guided in its groove. When the forces acting on the patella pull it toward the outside as the knee bends, the patella doesn’t track centrally but moves laterally. This maltracking is driven by a combination of factors that tilt the patella laterally, including a relatively large Q angle and dominance of lateral structures over medial stabilizers. Seeing the patella track laterally during knee motion is a classic mechanical sign of PFPS in a young patient, making lateral patellar tracking the best fit for this scenario.

Excessive foot supination isn’t the primary marker for this condition, and a decreased Q angle would actually lessen lateral pull, while weakness of the vastus lateralis wouldn’t promote lateral tracking and is not the typical pattern seen with PFPS.