Which factor is most commonly associated with lateral patellar tracking in patellofemoral syndrome?

• A. Decreased Q angle
• B. Increased Q angle is commonly associated with lateral patellar tracking
• C. No association with Q angle
• D. Femoral retroversion

Answer: (C)

Excessive lateral forces on the patella during knee extension drive lateral patellar tracking in patellofemoral syndrome. The key factor here is the Q angle, which reflects the alignment between the line of pull of the quadriceps and the patellar tendon. A larger Q angle shifts the quadriceps vector more laterally, increasing lateral tilt and glide of the patella as it tracks through the trochlear groove. This lateral tracking is a common finding in patellofemoral pain, making an increased Q angle the most consistently associated factor. Other contributors like femoral version or tibial torsion can play a role in some individuals, but they’re not as consistently linked to the lateral tracking pattern as an increased Q angle.