How is patellofemoral pain syndrome (PFPS) diagnosed?

During the exam for patellofemoral pain syndrome, the doctor feels your kneecap to look for tender spots, abnormal movements, and grinding under the kneecap as it moves (called crepitus), and to determine how easily the kneecap moves out of regular alignment. The doctor assesses the alignment of both knees and legs. An examination of your shoes may reveal whether your feet and ankles fall inward (pronation) or your feet need more arch support. X-rays and other imaging tests are reserved for later, if you fail to see improvement after several weeks of treatment.