I. Definition: Fabella

  1. Sesamoid bone of lateral gastrocnemius
  2. Normal variant in 10-20% of patients
  3. Posterior to lateral femoral condyle

II. Epidemiology

  1. More common in early teen years

III. Mechanism

  1. Friction of fabella on posterolateral femoral condyle

IV. Symptoms

  1. Slow, insidious pain onset
  2. Sharp, intermittent pain at posterolateral knee

V. Signs

  1. Localized tenderness over fabella
    1. Best examined with fully extended knee

VI. Management

  1. Conservative therapy
    1. RICE-M
    2. NSAIDs
    3. Heel lifts (shorten gastrocnemius)
  2. Surgical excision indications
    1. Failed conservative therapy after 6 month trial

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