II. Definition: Fabella

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

III. Epidemiology

  1. More common in early teen years

IV. Mechanism

  1. Friction of fabella on posterolateral femoral condyle

V. Symptoms

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

VI. Signs

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

VII. 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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