Dawaa Reference

acute

Chondromalacia patellae (retropatellar)

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources3 sources

Ibuprofen 100 mg/5 ml SmPC section 4.2 (eMC product 4560) · MSF Essential Drugs 2024 - paracetamol (oral) · Habusta SF, Coffey R, Ponnarasu S, et al. Chondromalacia Patella. [Updated 2023 Apr 22]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Bookshelf ID NBK459195; PMID 29083563.

Verified against2 documents
  • MSF Essential Drugs 2024 - paracetamol (oral)
  • SmPC section 4.2, https://www.medicines.org.uk/emc/product/4560/smpc

Verified date2026-08

Presentation reference

Is it this?

Reference only, to read alongside your own examination.

Symptoms — what the patient reports (4)

  • Pain in front of the knee is the leading complaint, often a vague, slow-onset ache behind or in front of the kneecap [joint pain · knee pain]
  • Stairs, squatting, kneeling, running, or sitting for a long time all make the pain worse - sometimes called theatre pain
  • Swelling, thigh-muscle wasting, and a grinding sensation behind the kneecap are all reported but none is specific to this diagnosis [crepitus · muscle wasting]
  • History-taking should cover past injury, other medical conditions, joint instability, and foot or ankle pain or dysfunction [foot pain · joint instability]

Signs — what you find (4)

  • Exam should look at thigh muscle bulk for wasting, and the alignment of the foot and ankle [muscle wasting]
  • Kneecap-specific exam covers pain, swelling, quad strength, how freely the kneecap moves, and grinding
  • Watch for signs the kneecap is tracking off-center - increased thigh-bone rotation, increased shin-bone twist, the kneecap slipping laterally, reduced inward glide, and a positive apprehension test
  • The Clark test - pressing the kneecap into the groove while the patient tightens the thigh muscle - specifically checks for grinding pain from this condition

Tests (8)

  • Plain x-rays miss early disease but in advanced stages can show cartilage breakdown, cysts, cartilage loss, or narrowed joint space
  • X-rays can also point to an underlying cause such as a shallow groove, a high- or low-riding kneecap, or lateral tilt
  • CT scanning can measure a specific alignment distance (TT-TG) and pick up rotational deformity of the leg
  • MRI is the preferred test for assessing the cartilage, with damaged cartilage showing up bright on T2 sequences
  • MRI is noninvasive, more consistent, and picks up more disease than arthroscopy does
  • On MRI, affected patients tend to show a shallower groove, a smaller tilt angle for the kneecap, and a wider sulcus angle
  • Thicker fat under the skin around the knee on MRI tracks with a worse disease grade, and is more pronounced in women
  • Arthroscopy is the single best way to see and size the cartilage damage directly, but its invasiveness makes noninvasive tests the preferred first step

If not this — what else fits (2)

  • Joint and cartilage mimics include an osteochondral fragment behind the kneecap, patellofemoral arthritis, patellofemoral pain syndrome, lateral compression syndrome, and plica syndrome
  • Soft-tissue and alignment mimics include tendinopathy of the quad or patellar tendon, a saphenous or postoperative neuroma, inflamed fat pad (Hoffa disease), a high- or low-riding or unstable kneecap, or a bipartite patella

SourceStatPearls "Chondromalacia Patella" - disease-level clinical article

Presentation findings are traced to the source above.

1

PARACETAMOL

1st line

Strength500 mg

Formoral.solid

Adult dose and duration

1 g three or four times daily, maximum 4 g in 24 hours - As needed for pain or fever

Paediatric dose

15 mg/kg/dose [child max 500 mg]

(Child 1 month and over: 15 mg/kg per dose, 3 or 4 times daily, maximum 60 mg/kg daily. Child under 1 month: 10 mg/kg per dose, 3 or 4 times daily, maximum 40 mg/kg daily. MSF's own weight table gives one 500 mg tablet three times daily from 30 kg to under 50 kg, so 500 mg is the per-dose ceiling; the 60 mg/kg daily total still applies.)

Dose by weight
3kg45 mg/dose
4kg60 mg/dose
5kg75 mg/dose
6kg90 mg/dose
7kg105 mg/dose
8kg120 mg/dose
9kg135 mg/dose
10kg150 mg/dose
11kg165 mg/dose
12kg180 mg/dose
13kg195 mg/dose
14kg210 mg/dose
15kg225 mg/dose
16kg240 mg/dose
17kg255 mg/dose
18kg270 mg/dose
19kg285 mg/dose
20kg300 mg/dose
21kg315 mg/dose
22kg330 mg/dose
23kg345 mg/dose
24kg360 mg/dose
25kg375 mg/dose
26kg390 mg/dose
27kg405 mg/dose
28kg420 mg/dose
29kg435 mg/dose
30kg450 mg/dose
31kg465 mg/dose
32kg480 mg/dose
33kg495 mg/dose
34kg500 mg/dose (capped)
35kg500 mg/dose (capped)
36kg500 mg/dose (capped)
37kg500 mg/dose (capped)
38kg500 mg/dose (capped)
39kg500 mg/dose (capped)
40kg500 mg/dose (capped)
41kg500 mg/dose (capped)
42kg500 mg/dose (capped)
43kg500 mg/dose (capped)
44kg500 mg/dose (capped)
45kg500 mg/dose (capped)
46kg500 mg/dose (capped)
47kg500 mg/dose (capped)
48kg500 mg/dose (capped)
49kg500 mg/dose (capped)
50kg500 mg/dose (capped)
Dose source

MSF Essential Drugs 2024 - paracetamol (oral)

Why

Standard analgesic dosing regardless of the cause of the knee pain.

Cautions
  • Persistent locking or a large effusion suggesting a different intra-articular problem.
  • Simple first-line analgesic for anterior knee pain.
  • Do not exceed 4 g in 24 hours.
  • Persistent locking or a large effusion suggests a different intra-articular problem and needs referral.
  • Administer with caution to patients with hepatic impairment.
Egyptian brands
Egyptian brandManufacturerIndicative price
FEBRIMOL 500 MG 20 TAB.PHARCO3.50 EGP (0.17/unit)
CETAMOL 500 MG 20 TABS.MEMPHIS8.00 EGP (0.40/unit)
PARACETAMOL-MUP 500MG B.P. 20 TABS.MUP13.00 EGP (0.65/unit)
CETAL 500 MG 20 TABS.EIPICO24.00 EGP (1.20/unit)
ARKADOLOW 500 MG 30 F.C. TABS.UTOPIA42.00 EGP (1.40/unit)
PARAMOL 500MG 20 TAB.MISR38.00 EGP (1.90/unit)
ADOL 500MG 24 CAPLETSJULPHAR32.00 EGP
AUGICETAMIDE 500 MG 20 SACHETSAUG PHARMA50.00 EGP
FEBRIMOL ORAL DROPS 20 ML? strength differs? different route - not oral solidPHARCO4.00 EGP
THERA-LO 3.2G/100ML ORAL SUSP. 100 ML? strength differs? different route - not oral solidPHAROPHARMA5.00 EGP
2

IBUPROFEN

2nd line

Strength400 mg

Formoral.solid

Adult dose and duration

200-400 mg PO Q6-8H PRN, max 1200 mg/day.

Paediatric dose

Age 3m+: 20-30 mg/kg/day divided Q6-8H PRN. (Dosed by age bands on liquid suspension labels).

Dose source

SmPC section 4.2, https://www.medicines.org.uk/emc/product/4560/smpc

Why

Standard NSAID analgesic dose for patellofemoral pain; the much higher anti-inflammatory pericarditis regimen is unnecessary for this non-inflammatory overuse condition.

Cautions
  • Use alongside quadriceps-strengthening physiotherapy and activity modification, which remain the mainstay of treatment.
  • Avoid in NSAID-exacerbated asthma, active peptic ulcer disease, or renal impairment.
  • Take with or after food.
Egyptian brands
Egyptian brandManufacturerIndicative price
DAJUANOFEN 400 MG 20 F.C. TABS.COPAD PHARMA5.00 EGP (0.25/unit)
FLABU 400MG 10 F.C.TAB.DELTA PHARMA3.75 EGP (0.38/unit)
NOVA-PROFEN 400MG 30 F.C. TABLETSSANOFI12.75 EGP (0.42/unit)
IBUPROFEN 400 MG 10 TAB.SEDICO6.00 EGP (0.60/unit)
MAFO 400 MG 30 F.C.TABSEIPICO42.00 EGP (1.40/unit)
BRUFEN 400 MG 30 TABS.KAHIRA > ABBOTT LABORATORIES78.00 EGP (2.60/unit)
PROFUSOL 400MG 20 S.G CAPS.EUROPEAN EGYPTIAN PHARM. IND.31.00 EGP
ANALGIPROF 400 MG 25 SACHETSEVA PHARMA37.50 EGP
NOVA-PROFEN 100MG/5ML ORAL SUSP. 100ML? strength differs? different route - not oral solidSANOFI2.25 EGP
BRUFEMOL-N SUSP. 60 ML? strength differs? different route - not oral solidARAB DRUG COMPANY (ADCO)4.50 EGP

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.