{ "schema_version": 1, "kind": "condition", "id": "patella-disorder", "name": "Patella disorder", "category": "chronic", "sources": "ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class LD69 - condition scope only, no dose · Patellofemoral Syndrome - StatPearls - NCBI Bookshelf - https://www.ncbi.nlm.nih.gov/books/NBK557657/ · MSF Essential Drugs 2024 - paracetamol (oral) · MSF Essential Drugs 2024 (ibuprofen oral monograph)", "review_status": "reviewed", "verified_against": "Patella disorder - disease-level clinical article (patella-disorder-full.txt) · MSF Essential Drugs 2024 - paracetamol (oral) · MSF Essential Drugs 2024 (ibuprofen oral monograph)", "verified_date": "2026-08", "treatments": [ { "id": 1390, "generic": "Paracetamol", "line": 1, "is_adjunct": false, "form": "oral.solid", "strength_mg": 500.0, "adult_dose": "1 g (two 500 mg tablets) 3 or 4 times daily, to a maximum of 4 g in 24 hours.", "adult_duration": "While the knee is painful, alongside physiotherapy.", "dose_source": "MSF Essential Drugs 2024 - paracetamol (oral)", "rationale": "Paracetamol covers the analgesia half of that pathway and is usable where an NSAID is barred. For a first-time patellar dislocation with no loose body and no intra-articular damage, the article's mainstay is conservative: analgesia, icing and NSAIDs to reduce pain and swelling, physiotherapy, bracing for two to four weeks and activity modification. It names no drug and no amount, so the amount is MSF's.", "cautions": [ "A large tense effusion, a knee that locks, or a first dislocation with an osteochondral fragment needs prompt surgical assessment - the swelling settling on an analgesic is not the answer to those.", "Never exceed 4 g in 24 hours in an adult, or 60 mg/kg in 24 hours in a child. MSF warns that paracetamol poisoning is severe - it causes hepatic cytolysis - and that the stated limits matter most in children and in older patients.", "MSF records no contra-indication in pregnancy or in breast-feeding, and names paracetamol as the analgesic of choice for a patient allergic to aspirin, one with a history of gastric trouble, a pregnant or breast-feeding woman, and children.", "Paracetamol has no anti-inflammatory action, so it eases the pain and does nothing for the swelling." ], "peds_mgkg_low": 15.0, "peds_mgkg_high": 15.0, "peds_max_mg": 500.0, "peds_basis": "dose", "peds_unit": "mg", "peds_note": "Child 1 month and over: 15 mg/kg 3 or 4 times daily, to a maximum of 60 mg/kg in 24 hours. Child under 1 month: 10 mg/kg 3 or 4 times daily, to a maximum of 40 mg/kg in 24 hours. A single dose is capped at 500 mg because the top band of MSF's own weight table, 30 to under 50 kg, is one 500 mg tablet three times daily.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": [ { "weight_kg": 10, "low_mg": 150, "high_mg": 150, "capped": false }, { "weight_kg": 20, "low_mg": 300, "high_mg": 300, "capped": false }, { "weight_kg": 30, "low_mg": 450, "high_mg": 450, "capped": false }, { "weight_kg": 40, "low_mg": 500, "high_mg": 500, "capped": true } ], "brands": [ { "trade_name": "FEBRIMOL 500 MG 20 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHARCO", "price_egp": 3.5, "pack_count": 20, "unit_price": 0.17, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CETAMOL 500 MG 20 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MEMPHIS", "price_egp": 8.0, "pack_count": 20, "unit_price": 0.4, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "PARACETAMOL-MUP 500MG B.P. 20 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MUP", "price_egp": 13.0, "pack_count": 20, "unit_price": 0.65, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CETAL 500 MG 20 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EIPICO", "price_egp": 24.0, "pack_count": 20, "unit_price": 1.2, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ARKADOLOW 500 MG 30 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "UTOPIA", "price_egp": 42.0, "pack_count": 30, "unit_price": 1.4, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "PARAMOL 500MG 20 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MISR", "price_egp": 38.0, "pack_count": 20, "unit_price": 1.9, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ADOL 500MG 24 CAPLETS", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "JULPHAR", "price_egp": 32.0, "pack_count": null, "unit_price": null, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "AUGICETAMIDE 500 MG 20 SACHETS", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "AUG PHARMA", "price_egp": 50.0, "pack_count": null, "unit_price": null, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "FEBRIMOL ORAL DROPS 20 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHARCO", "price_egp": 4.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null }, { "trade_name": "THERA-LO 3.2G/100ML ORAL SUSP. 100 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHAROPHARMA", "price_egp": 5.0, "pack_count": null, "unit_price": null, "strength_mg": 3200.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null } ], "condition_id": "patella-disorder" }, { "id": 1391, "generic": "Ibuprofen", "line": 1, "is_adjunct": false, "form": "oral.solid", "strength_mg": 400.0, "adult_dose": "200 to 400 mg 3 to 4 times daily as required, to a maximum of 1,200 mg in 24 hours. Take it with food and keep doses at least 4 hours apart.", "adult_duration": "A short course while the knee is swollen and painful.", "dose_source": "MSF Essential Drugs 2024 (ibuprofen oral monograph)", "rationale": "Ibuprofen is the NSAID half of that pathway; MSF indicates it for mild to moderate pain and it acts on the swelling as well. For a first-time patellar dislocation with no loose body and no intra-articular damage, the article's mainstay is conservative: analgesia, icing and NSAIDs to reduce pain and swelling, physiotherapy, bracing for two to four weeks and activity modification. It names no drug and no amount, so the amount is MSF's.", "cautions": [ "Failure to improve on conservative treatment where the anatomy predisposes to instability is a reason for surgical referral, not for a longer course.", "Not for a child under 3 months. MSF also contra-indicates ibuprofen in allergy to any NSAID, peptic ulcer, coagulation defects, haemorrhage, surgery carrying a risk of major blood loss, severe renal or hepatic impairment, severe heart failure, severe malnutrition, uncorrected dehydration or hypovolaemia, and severe infection.", "Avoid in pregnancy. MSF contra-indicates it outright from the beginning of the sixth month and names paracetamol as the substitute. Short-term use while breast-feeding carries no contra-indication.", "Give with caution to an older or an asthmatic patient. Do not combine it with methotrexate, with an anticoagulant, or with another NSAID, and watch the combination with a diuretic or an ACE inhibitor - MSF's instruction there is to drink plenty of fluids to avoid renal failure.", "It may cause allergic reactions, epigastric pain, peptic ulcer, haemorrhage and renal impairment." ], "peds_mgkg_low": 5.0, "peds_mgkg_high": 10.0, "peds_max_mg": 400.0, "peds_basis": "dose", "peds_unit": "mg", "peds_note": "Child over 3 months: 5 to 10 mg/kg 3 to 4 times daily, to a maximum of 30 mg/kg in 24 hours. Nothing under 3 months of age. A single dose is capped at 400 mg, which is the adult single-dose maximum in the same MSF entry.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": [ { "weight_kg": 10, "low_mg": 50, "high_mg": 100, "capped": false }, { "weight_kg": 20, "low_mg": 100, "high_mg": 200, "capped": false }, { "weight_kg": 30, "low_mg": 150, "high_mg": 300, "capped": false }, { "weight_kg": 40, "low_mg": 200, "high_mg": 400, "capped": false } ], "brands": [ { "trade_name": "DAJUANOFEN 400 MG 20 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "COPAD PHARMA", "price_egp": 5.0, "pack_count": 20, "unit_price": 0.25, "strength_mg": 400.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "FLABU 400MG 10 F.C.TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "DELTA PHARMA", "price_egp": 3.75, "pack_count": 10, "unit_price": 0.38, "strength_mg": 400.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "NOVA-PROFEN 400MG 30 F.C. TABLETS", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SANOFI", "price_egp": 12.75, "pack_count": 30, "unit_price": 0.42, "strength_mg": 400.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "IBUPROFEN 400 MG 10 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SEDICO", "price_egp": 6.0, "pack_count": 10, "unit_price": 0.6, "strength_mg": 400.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "MAFO 400 MG 30 F.C.TABS", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EIPICO", "price_egp": 42.0, "pack_count": 30, "unit_price": 1.4, "strength_mg": 400.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "BRUFEN 400 MG 30 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "KAHIRA > ABBOTT LABORATORIES", "price_egp": 78.0, "pack_count": 30, "unit_price": 2.6, "strength_mg": 400.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "PROFUSOL 400MG 20 S.G CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EUROPEAN EGYPTIAN PHARM. IND.", "price_egp": 31.0, "pack_count": null, "unit_price": null, "strength_mg": 400.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ANALGIPROF 400 MG 25 SACHETS", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EVA PHARMA", "price_egp": 37.5, "pack_count": null, "unit_price": null, "strength_mg": 400.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "NOVA-PROFEN 100MG/5ML ORAL SUSP. 100ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SANOFI", "price_egp": 2.25, "pack_count": null, "unit_price": null, "strength_mg": 100.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null }, { "trade_name": "BRUFEMOL-N SUSP. 60 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ARAB DRUG COMPANY (ADCO)", "price_egp": 4.5, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null } ], "condition_id": "patella-disorder" }, { "id": 1392, "generic": "Referral & safety-netting (no drug therapy)", "line": 1, "is_adjunct": false, "form": null, "strength_mg": null, "adult_dose": "Umbrella term for kneecap disorders including recurrent patellar instability; the GP manages pain and refers for physiotherapy or surgical stabilisation when instability recurs.", "adult_duration": "Refer, with advice", "dose_source": "No dose - referral pathway, no medicine given in primary care", "rationale": "Umbrella term for kneecap disorders including recurrent patellar instability; the GP manages pain and refers for physiotherapy or surgical stabilisation when instability recurs.", "cautions": [ "Recurrent frank dislocation, large knee effusion, locking suggesting a loose body.", "The drug rows above are what the treating service gives. They are here so that the referral is an informed one and so the GP can recognise the regimen the patient comes back on - not as permission to start it without the referral.", "RED FLAG - First-time patellar dislocation accompanied by an osteochondral fracture or loose body requires prompt surgical evaluation/management.", "RED FLAG - Failure to improve with conservative management in the presence of predisposing anatomical factors warrants surgical referral." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "A child is dosed from the drug rows above, by weight. The referral threshold and the safety-netting are the same at any age.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [], "condition_id": "patella-disorder" } ] }