Case report:
A 48 year-old male patient presented to our clinic with lateral right
knee snapping and pain that had been ongoing for over 2 years without
trauma or other known cause. The patient noted the pain and snapping at
the fibular head worsened with cycling and deep squats. On examination,
no atrophy was noted, however snapping was visible at knee flexion past
90 degrees. The patient had attempted activity modification, a
home-exercise program and icing without relief. Radiographs of the knee
were unremarkable with no evidence of any osseous abnormalities or bony
prominences at the fibular head. MRI imaging of the right knee did not
indicate evidence of an anatomical variant or anomalous insertion of the
biceps femoris tendon (Figure 1). After 8 weeks of physical therapy
focused on knee conditioning and hamstring strengthening, the patient
reported worsening of symptoms and elected to proceed with surgery since
conservative options had been exhausted.