[Anterior knee pain in children and adolescents. Diagnosis and conservative treatment].

Anterior knee pain is a common problem in childhood and adolescence with a prevalence of 4-30% in regional surveys. Although different etiologic theories are discussed in a large number of published studies, most cases are probably attributed to lower extremity malalignment, muscular imbalance, or physical overactivity (or even a combination of all three). Thorough clinical investigation should result in a definition of relevant static or functional problems as underlying causes of the disease. Radiographic analysis is mainly performed to exclude severe pathology (i.e., malignancies), as the correlation between described morphometric variables and clinical problems is weak. Prior to therapeutic recommendations, the benign natural course of the disease should be discussed with patients and their parents. In a large number of published studies with different conservative treatment protocols, positive results for many regimens are reported. The size,however, is not always large enough to prove superior outcome when compared to the natural course of the disease. There is also no evidence to support the superiority of one physiotherapy intervention over others.