Patellofemoral pain syndrome is commonly evaluated with which test that elicits patellofemoral grinding?

• A. Patellar apprehension test
• B. McConnell test for patellofemoral tracking
• C. Apley grind test for the knee
• D. Patellar grind test (Clarke’s sign)

Answer: (D)

Patellofemoral pain syndrome is evaluated by provoking the patellofemoral joint to reproduce symptoms. The patellar grind test, or Clarke’s sign, does exactly that: with the knee flexed about 20–30 degrees, apply downward pressure on the patella as the patient contracts the quadriceps. If this produces anterior knee pain or a grinding/crepitus sensation as the patella tracks in the trochlear groove, the test is positive, supporting patellofemoral pathology.

Other tests described don’t specifically elicit patellofemoral grinding: the patellar apprehension test checks for lateral instability or fear of dislocation; the McConnell test focuses on patellofemoral pain with resisted knee extension and tracking; and the Apley grind test targets meniscal pathology in the tibiofemoral joint.