Chondromalacia meaning softening of the patellar cartilage, is a common misdiagnosis. Softening of the cartilage can only be detected by directly visualizing the cartilage during surgery. The correct diagnosis for pain and swelling originating from under the kneecap is Patello-femoral Pain.
Treatment includes pain relief with rest, ice, compression, and elevation. Swelling must be controlled. Anti-inflammatory medications, bracing, and physical therapy are often helpful. Progressive strengthening of the quadriceps is essential. Occasionally, foot orthoses may be helpful. Rarely, surgery is required to assist in realigning the kneecap by releasing the tight structures on the outside of the kneecap and reefing the inner structures.