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Anterior knee pain is a common complaint in the pediatric and adolescent population. Multiple etiologies can be responsible for the onset of pain in this demographic. One etiology of this pain can be a pathologic plica. Plica are synovial folds within the knee that can become inflamed / fibrotic through both acute and chronic processes. A focused physical exam with appropriate imaging can lead to this diagnosis, particularly when other pathologies have been ruled out. Conservative management in the form of rest, anti-inflammatories, and physical therapy can help to alleviate the vast majority of cases that present with pain. In selected cases, arthroscopic resection can lead to good functional results.