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Cluster of Cook 2/3

Patellofemoral Pain Syndrome

Source: Physiotutors

Execution

  1. 1Ask the patient to squat and record whether familiar anterior knee pain occurs.
  2. 2Ask whether stair ascent or descent reproduces familiar anterior knee pain.
  3. 3Confirm symptoms are retropatellar or peripatellar rather than tendon or joint-line dominant.
  4. 4Count the cluster positive when squat pain and stair pain are present.
  5. 5Integrate the result with functional observation and differential testing.

Positive outcome

The cluster is positive when both squat pain and stair pain reproduce the patient's familiar anterior knee pain. The finding supports PFPS when other causes of anterior knee pain are not dominant. It is a classification aid, not a structural test.

Studies

StudyReliabilitySnSpLR+LR−
Cook et al. (2010)NANANANANA
Cook et al. (2012)systematic reviewNANANANA

CommentSquat and stairs are high-load patellofemoral tasks, so this cluster is clinically intuitive. It can also be positive in patellar tendinopathy or OA, so localization and palpation matter. Use it as a PFPS classifier rather than a tissue diagnosis.

High Clinical Value

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