Evidence Checklist: Patellofemoral Pain Syndrome

Orthopedic evaluation with patellar tracking and range of motion assessmentCritical

Examination documenting anterior knee pain with activity (stairs, squatting, prolonged sitting), patellar compression test, patellar tilt/glide assessment, Q-angle measurement, and knee range of motion in degrees.

Nexus opinion linking patellofemoral pain syndrome to service ("at least as likely as not")Critical

A medical opinion connecting your PFPS to military service, including running, marching, load-bearing activities, kneeling, or a specific in-service knee injury.

Imaging (X-ray patellar views; MRI showing cartilage changes)

Sunrise (axial) and merchant views documenting patellofemoral joint congruence angle and tilt. MRI documenting subchondral edema, cartilage softening, or patellar maltracking.

Documentation of activity limitations (stairs, running, prolonged sitting)

Records documenting the specific activities that provoke pain and the degree to which patellofemoral symptoms limit daily function, work capacity, and recreational activities.

Treatment records (physical therapy, bracing, taping, injections)

Records documenting quadriceps and VMO strengthening physical therapy, patellar taping (McConnell technique), knee brace or sleeve use, and any injection therapy.

Buddy statement from spouse, family, or fellow service member

A written statement from someone who can describe observable symptoms and how your condition affects daily life.

Personal statement describing symptoms and functional impact

Your own written account of how this condition affects your daily activities, work, and relationships. Describe your worst days.

Completed DBQ Knee and Lower Leg ConditionsCritical

Standardized form capturing knee range of motion, patellofemoral findings, pain, and functional limitations.

Service treatment records (STRs)Critical

Military medical records showing in-service treatment, complaints, or injuries related to this condition.