ROUNDS RESPONSE.
Rounds is your vehicle for sharing your orthopaedic skills and experience. Your response to Rounds will be published in a future issue of Body Cast. We invite you to suggest questions for this column. Please address all submissions to:
The Editor,
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In the last issue of Body Cast, Rounds asked: What is Plica syndrome?
The following answers were received:

From Mark Florian:
Plica syndrome happens when the plica becomes irritated or inflamed, often caused by plica being caught on the
femur. It is usually treated by NSAIDs and with therapeutic exercises.

From Dalphine Edwards:
Plica syndrome occurs when the plica (an extension of the protective synovial capsule of the knee) becomes irritated and
inflamed secondary to injury or overuse.

From John Delsey:
Plica syndrome, also known as synovial plica syndrome, occurs when the knee becomes painful and inflamed due to
an injury or overuse. Plica is a term used to describe a fold in the synovial tissue lining of the knee joint. There are four
plica synovial folds in the knee. The medial plica is a fold of synovial tissue most prone to irritation and injury. When the
knee is bent, the plica is exposed to direct injury. This may lead to scarring and thickening of the plica tissue later.
The primary symptom is pain around the knee joint. There may also be a snapping sensation when the knee is bent. This
is due to thickened tissue rubbing over the medial femoral condyle.

In most cases treatment can be conservative. The primary goal is to reduce the inflammation of the plica. This is achieved by limiting activities such as running and cycling. An anti-inflammatory may be prescribed or an injection of cortisone
may be used initially to reduce the swelling. Ice may be used to reduce inflammation. If non-surgical treatment fails,
arthroscopic surgery may be suggested.

From Mary Anne Christenson:
A patient may present with knee pain due to injury or overuse. Plica is a word used to describe a fold in the lining of the knee joint. Synovial tissue lines all joints. The tissue has folds that allow unrestricted movement of the joint. Should the plica become irritated with overuse, repetitive motions, or injury it may become swollen and painful. The injury may lead to
scarring and thickening of the plica tissue. This results in pain, discomfort and restriction of use.

Answers were also received from: R. Aceron, J. Anderson, D. Brooks, T Broughton, M. Buchner, L. Burk, F. Carrozza,
E. Carroll, L. Chen, R. Chun, E. Clancey, A. Crossman, B. Doucet, W Fast, H. Fehr, C. Gaudon, D. Gauthier, E. Hewer,
S. Jankowski, S. Ko, B. Lavallee, B. Letourneau, N. Lockyer, C. Longphee, G. Marshall, B. Matheson, J. Maulucci, J.
Movasseli, E. Oborowsky, T Ogden, J. Piche, J. Pike, O. Picton, P. Power, L. Pirzale, J. Punwassie, B. Rawlings,
V. Robichaud, B. Sheppard, S. Shivpaul, A. Tarambikos, S. Tilley, C. Thompson, A. Wentzell, B. Walker, T White, R. Wong,
N. Yao, T. Yorke and M. Young.