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  1. The Inter-Rater Reliability and Diagnostic Accuracy of Patellar Mobility Tests in Patients with Anterior Knee Pain (The Physician and Sportsmedicine) by Brett A. Sweitzer, Chad Cook, et all 2010-10-24

41. CHIROWEB | DC Archives - (Treatment For Patellofemoral Pain Syndrome)
Treatment for Patellofemoral pain syndrome. by Warren Hammer,MS,DC,DABCO. The etiology and treatment of anterior knee pain is often difficult to determine,
http://www.chiroweb.com/archives/19/04/07.html
Dynamic Chiropractic
February 12, 2001, Volume 19, Issue 04
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Treatment for Patellofemoral Pain Syndrome
by Warren Hammer,MS,DC,DABCO The etiology and treatment of anterior knee pain is often difficult to determine, as evidenced by the variety of procedures and treatments that have been proposed. The pathology called chondromalacia patella is often used as a "catch-all" diagnosis. Lateral malalignment of the patella caused by inadequate activation of the vastus medialis obliquus; tight lateral soft tissue structures; bony malalignment; patellar tilt or rotation due to imbalance of the retinacular restraints; or patella malalignment are some of the etiologies mentioned. Soft tissue surgery, such as lateral retinacular release, proximal or distal reconstruction of the extensor mechanism, and resection of a symptomatic plica are some of the surgical methods used for this problem. Patellar taping to improve patella alignment and quadriceps function has proven beneficial, especially in relieving pain and allowing painless rehabilitation. Why taping works has not been fully evaluated.

42. American Family Physician: Anterior Knee Pain: The Challenge Of Patellofemoral S
anterior knee pain the challenge of patellofemoral syndrome includes patient 1 Among runners, anterior knee pain is reported to be one of the most
http://www.findarticles.com/p/articles/mi_m3225/is_n1_v47/ai_13411368
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ABNF Journal, The AIDS Treatment News AMAA Journal ... View all titles in this topic Hot New Articles by Topic Automotive Sports Top Articles Ever by Topic Automotive Sports Anterior knee pain: the challenge of patellofemoral syndrome - includes patient information handout - Practical Therapeutics American Family Physician Jan, 1993 by Mack T. Ruffin, IV Robert B. Kiningham
Save a personal copy of this article and quickly find it again with Furl.net. It's free! Save it. Pain in the anterior region of the knee is one of the most common musculoskeletal complaints in children, adolescents and adults. Difficult and frustrating for the patient to endure, the disorder is also difficult for the physician to manage. The precipitating events and the location and duration of the pain are important factors in narrowing the differential diagnosis. A detailed physical examination further aids in the differential diagnosis. The treatment and rehabilitation of patellofemoral dysfunction, the most common cause of anterior knee pain, has four phasesacute, subacute, chronic and maintenance. These phases involve medication, a structured knee exercise program and activity modification before returning to normal activity. More than 80 percent of patients with patellofemoral dysfunction respond well to a nonsurgical approach.

43. American Family Physician: Evaluation Of Patients Presenting With Knee Pain: Par
anterior knee pain. Patients with patellofemoral pain syndrome (8) Patellofemoral pain syndrome is a common cause of anterior knee pain in women.
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44. Chondromalacia Patellae
patellofemoral pain syndrome, patello-femoral stress syndrome, anterior knee pain, CMP Definition Chondromalacia patella (CMP) is a syndrome involving
http://www.northmemorial.com/healthencyclopedia/content/2606.asp
chondromalacia patellae
Alternative Names

patello-femoral pain syndrome, patello-femoral stress syndrome, anterior knee pain, CMP
Definition
Chondromalacia patella (CMP) is a syndrome involving discomfort at the front of the knee. It is associated with irritation or wear on the underside of the kneecap, or patella.
What is going on in the body?
Normally, the cartilage on the underside of the kneecap glides smoothly over the surface of the thighbone, or femur. The cartilage may become soft or rough due to the normal aging process, overuse, or injury.
What are the signs and symptoms of the condition?
Symptoms include pain on the front of the knee, particularly during stair climbing. The pain may also occur after the person has been sitting for too long, squatting, or exercising. Sometimes a feeling of stiffness of the knee or buckling can occur.
Signs include clicking or rubbing of the kneecap that can be felt by a healthcare provider during bending and straightening of the knee. There may be tenderness around the kneecap, especially in the lower, inside area. Sometimes there is limitation of or pain during knee flexing.
What are the causes and risks of the condition?

45. The Department Of Orthopaedic Surgery
Other names for this syndrome include retropatellar pain, anterior knee pain, and chondromalacia patellae. None of these terms accurately describe the
http://www.hopkinsmedicine.org/orthopedicsurgery/patellofemoral.html
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return to top of page return to top of page Patient Guide to Patellofemoral Pain Syndrome (PFPS)
Edward G. McFarland, M.D.
Andrew Cosgarea, M.D.
Brian J. Krabak, M.D. What is patellofemoral pain syndrome?
Patellofemoral pain syndrome is a term used to describe pain originating from the region of the patella (kneecap) and femur (thigh bone). It is an extremely common entity and probably the most common complaint of athletes and nonathletes presenting to the physicians who take care of knee problems. Other names for this syndrome include: retropatellar pain, anterior knee pain, and chondromalacia patellae. None of these terms accurately describe the cause of this pain, which remains elusive and poorly understood.
What are the signs and symptoms of patellofemoral pain syndrome?
What causes patellofemoral pain syndrome?

46. Acupuncture Relieves Knee Pain - Acupuncture Today
anterior knee pain in adolescents. Clin J Sports Med 1994;4176181. Karlsson J, et al. Eleven year followup of patellofemoral pain syndrome.
http://www.acupuncturetoday.com/archives2000/apr/04kneepain.html
Acupuncture Today
April, 2000, Volume 01, Issue 04
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Acupuncture Relieves Knee Pain Study Finds "Clear, Durable Effect" in Reducing Pain and Improving Function
By Michael Devitt, Managing Editor According to the National Institutes of Health, more than four million people seek medical care for a knee problem each year. A leading cause of chronic knee pain, particularly in young adults, is patellofemoral pain syndrome (PFPS). The condition occurs most frequently in adolescents who participate in sports, and is one of the most common diagnoses given at orthopedic centers and sports medicine clinics worldwide. Despite its prevalence, the contributing factors to patellofemoral pain syndrome are unclear. Although several studies have linked knee pain to certain physical activities, there seems to be no direct correlation between the level of pain and the degree of cartilage damage to one's knee, or to the amount of flexion or extension a person's knee experiences. To date, no single therapy has been shown to be completely effective in treating PFPS. However, acupuncture has shown promise in treating similar conditions such as gonarthrosis and osteoarthritis of the knee.

47. Womens Player Committee
anterior knee pain (AKP) is a common occurrence in patients of all ages and Click here to view Patellofemoral pain syndrome rehabilitayion diagram
http://www.gbtennisgirls.com/html/resource/knee-pain.htm
Anterior Knee Pain Anterior Knee Pain (AKP) is a common occurrence in patients of all ages and levels of activity. AKP is a symptom and not a diagnosis. It can involve any condition where there is pain, inflammation, muscle imbalance or instability of the extensor mechanism of the knee. AKP can affect up to 60% of athletes and once present, if not treated appropriately, it can become a chronic problem.
Conditions which can cause AKP are as follows:
COMMON
Patellofemoral pain syndrome
Patellar tendonitis
Iliotibial band friction syndrome
Chondromalacia patellae
Patellar subluxation
Fat pad syndromes LESS COMMON
Plica syndrome
Patellofemoral osteoarthritis Pre- and infra-patellar bursitis Intra-articular pathology eg. Meniscal tears Patellar stress fracture Traction Apophysitis ( Osgood Schlatter Syndrome, Sinding-Larson Syndrome) Pain referred from hip and spine Excessive lateral pressure syndrome(ELPS) Patellofemoral Pain Syndrome (PFPS) Click here to view Patellofemoral pain syndrome rehabilitayion diagram PFPS is defined as pain associated with abnormal loading of the patellofemoral joint (PFJ) of the knee. It should only be diagnosed when other causes of anterior knee pain have been excluded. It is thought that mal-tracking of the patella may be the cause resulting in stressing the peripatellar retinacular supports and the articular cartilage of the patellofemoral joint. The patient often complains of pain behind the knee-cap which has occurred for more than six weeks during physical activities such as jumping, running, squatting and walking downstairs. The athlete may also complain of pseudo-locking and giving way. Pain can even occur on prolonged sitting ("Theatre goers knee")

48. Research + Anterior Knee Pain In Athletes: Surgical Management
Chondromalacia, like anterior knee pain, is not a syndrome. Chondromalacia is the pathological appearance of fragmentation of the articular surface of the
http://www.orthopaedics.co.uk/boc/v2rinfo6.htm
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Research Papers and Topics
Anterior Knee Pain in Athletes: Surgical Management
David P Johnson Optimum knee function is of vital importance in a wide variety of sports. Knee stability is important in runniing, twisting, jumping and pivoting. Injuries to the knee are very common because of the lack of bony congruity and its reliance on muscular and ligamentous support. Knee injuries are the most common serious injury during sporting activities. Anterior knee pain affects 29% of adolescent children (Fairbank 1984). This may be related to the increase in structured sporting activity which occurs at school during early adolescence. Anterior knee pain is particularly prevalent in certain sports which include basketball, netball, athletics, skiing and cyclling. In these sports activities are undertaken whilst the knee is in a flexed position, and or jumping is common. To understand the patho-mechanics of anterior knee pain, the anatony, clinical examination and mechanics of the knee must be well understood. Much of the confusion surrounding anterior knee pain has been produced by the inability of the practitioner to translate distinct clinical problems into a specific classification. This applies whether they be a general practitioner or hospital consultant (Ref).

49. Iliotibial Band Syndrome-Patellofemoral Pain-Runner's Knee, Running- Goode Wraps
Iliotibial Band syndrome Runner s knee pain Wraps - Patelloformal pain anterior knee pain, Jumper s knee -Goode Wraps May Relieve pain - Men s (Mens)
http://www.200.com/kneemeta.htm
Do You Have Runner's Knee ( Runners ) Goode Wraps Relieve Pain, Swelling and Stiffness from Iliotibial Band Syndrome ( runners knee ) by Relaxing Muscles and Tendons ILIOTIBIAL BAND SYNDROME - IT - PATELLOFEMORAL PAIN - RUNNER'S KNEE RUNNERS , RUNNING Patellqfemoral Pain Syndrome Cycling Iliotibial Band Soccer Runner's Knee Basketball Patellafemoral Baseball Runners Knee Volleyball Softball Football Gymnastics Golf Swimming Jogging Bowling Cycling Running The most common cause of knee (and hip pain) in cyclists is iliotibial band (IT band) syndrome. The IT band is a thick fibrous band of tissue, which runs on the outside of the leg from the hip to the knee. Pain is caused when the band becomes tight and rubs over the bony prominences of the hip (greater trochanter) and/or the knee (lateral epicondyle). Tight inflexible lower extremity muscles may worsen the condition. syndrome0,band,runner's knee, Basketball, volleyball, running - all of these activities involve repetitive running and/or jumping and could cause a very painful knee condition called patellar tendinitis, Iliotibial Band Syndrome or Patellofemorial known as "runner's knee". The act of jumping, especially, puts a great deal of stress on the patellar tendon, which attaches to the bottom of your kneecap. The force of hitting the ground repeatedly could cause the tendon to become inflamed and even begin to tear.
Iliotibial band syndrome (runner's knee) is usually felt in the front of the knee just below the kneecap and may be felt during or after vigorous running or jumping. You may also experience discomfort when you sit down and extend your leg straight out.

50. IngentaConnect Anterior Knee Pain
Idiopathic anterior knee pain, also known as patellofemoral pain syndrome The main presentation of PFPS is spontaneous onset of anterior knee pain
http://www.ingentaconnect.com/content/arn/ta/2005/00000007/00000001/art00002

51. Occurrence And Prevention Of Anterior Knee Pain
Of anterior knee pain. Potential summer knee injuries include a fall while By far the most common cause of AKP is patellofemoral pain syndrome (PFPS).
http://www.acofp.org/member_publications/0704_1.html
Occurrence and Prevention
Of Anterior Knee Pain Potential summer knee injuries include a fall while rock
climbing or twisting injuries during high speed lateral sports. By Christopher J. Mehallo, DO A nterior knee pain (AKP) is a very common presenting complaint in both the sports medicine and family medicine clinic. The anterior aspect of the knee is mainly composed of the patellofemoral joint (PFJ). This articulation comprises a vast array of bony, cartilaginous, and soft tissue structures. The articular cartilage of the patella may be up to five millimeters thick, and is the thickest in the body.
The soft tissues surrounding the patella are very complex and act as static and dynamic stabilizers of the patella. Forces in the patellar tendon have been shown to be as high as 17.5 times the body weight in weight lifters. The knee joint receives innervation from branches of the obturator, tibial, femoral, common peroneal, and saphenous nerves.
AKP presents with a variety of clinical findings because of the complex innervation of the knee and because any one structure or combination of bony and soft tissue structures may cause pain. Table 1 lists the causes of AKP.

52. Patellofemoral Pain Syndrome
Patellofemoral pain syndrome. The Use Of Electromyographic Biofeedback For Training anterior knee pain is often diagnosed as chondromalacia patella(2).
http://www.bfe.org/protocol/pro01eng.htm
Patellofemoral Pain Syndrome
The Use Of Electromyographic Biofeedback For Training The Vastus Medialis Obliquus In Patients With Patellofemoral Pain.
Charles R.Felder, PT, SCS, ATC
Maureen A. Leeson, B.App.Sc.(Phty) Introduction Patellofemoral pain is a common ailment affecting one in four of the general population(6). It is caused by a variety of factors including abnormal lower limb mechanics, Vastus Medialis Obliquus (VMO) insufficiency, tight lateral structures and tight anterior and posterior muscles. The condition often develops gradually and is characterized by a diffuse ache in the area of the anterior knee. Pain is a significant factor since it will inhibit muscular activity and alter lower limb function. Anterior knee pain is often diagnosed as chondromalacia patella(2). This diagnosis is only correct when a softened and fissured patellar under-surface is seen during diagnostic imaging or surgery(2). Often, no cartilaginous pathological findings are present in patients who otherwise complain of severe knee pain and functional disability, especially during prolonged sitting, stair climbing or sporting activities. The VMO muscle is the dynamic medial stabilizer of the patella. Therefore it is important to understand the anatomy and function of the VMO when treating patients with patellofemoral dysfunction. The fibers of the VMO insert into the patella at an angle of 50-55 degrees from the vertical axis(10)(see figure 1). The VMO is active throughout the full range of extension of the knee and is the only dynamic medial stabilizer of the patella(4). Insufficiency of the VMO will contribute to lateral tracking of the patella(3). Training the VMO is important to prevent lateral tracking of the patella and eliminate patellofemoral dysfunction.

53. ► Anterior Knee Pain
A medical encycopedia article on the topic anterior knee pain. Alternative Names. knee pain - runner s condition; Patellofemoral stress syndrome
http://www.umm.edu/ency/article/001259.htm
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Anterior knee pain
Overview Symptoms Treatment Prevention Definition:
Knee pain caused by misalignment of the patello-femoral joint (where the kneecap articulates with the end of the thigh bone).
Alternative Names: Knee pain - runner's condition; Patellofemoral stress syndrome
Considerations: A physical examination of the knee will confirm the presence of a painful joint.
Tests that may be performed to rule out possible structural damage to the knee or connective tissue:
Causes: The most common cause of runner's knee is pronation and lateral (away from the middle) pulling of the patella. This causes misalignment with the connective tissues and muscles involved with knee movement.
Review Date: 5/30/2001
Reviewed By: Benjamin D. Roye, M.D., M.P.H., Department of Orthopaedics, New York-Presbyterian Hospital, New York, NY. Review provided by VeriMed Healthcare Network.

54. Chondromalacia Patellae
is the softening and degeneration of the cartilage beneath the kneecap (patella). Alternative Names. Patellofemoral syndrome; anterior knee pain
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Chondromalacia patellae
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Chondromalacia patellae
Definition: Chondromalacia patellae is the softening and degeneration of the cartilage beneath the kneecap (patella).
Alternative Names: Patellofemoral syndrome; Anterior knee pain
Causes, incidence, and risk factors: Chondromalacia patella that occurs in adolescents and young adults is thought to be related to overuse, trauma, and/or abnormal forces on the knee. It is more common in females. Many affected adolescents have a mildly abnormal alignment of the kneecap. Chondromalacia patella may also reflect arthritis of the kneecap, which is usually seen in older individuals.

55. Retropatellar Pain Syndrome
Other names for this entity are retropatellar pain syndrome,(1) Home Up Adolescent anterior knee pain anterior Cruciate Ligament ACL
http://www.health-nexus.com/retropatellar_pain_syndrome.htm
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Retropatellar Pain Syndrome
Knee1.com - Retropatellar Pain Syndrome Retropatellar Pain Syndrome...
American Family Physician: Patellofemoral pain syndrome ... Other names for this entity are retropatellar pain syndrome,(1) patellofemoral arthralgia,(2) extensor mechanism disorder,(3) lateral patellar compression ..
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56. Knee Pain 2
Causes of knee pain. Most knee injuries involve a blow, a sudden twist, Runner’s knee, also called patellofemoral pain syndrome or anterior knee pain,
http://www.parknicollet.com/healthadvisor/conditions/kneepain_2.cfm
Causes of Knee Pain Most knee injuries involve a blow, a sudden twist, or a hard landing after a jump. A single strong blow in just the right place can tear cartilage and sprain several ligaments. Sprains The same kind of traumas that cause sprains also can tear the menisci. Repeated squatting or kneeling also can weaken menisci, increasing the risk of injury. Swelling may happen immediately or appear within 24 hours. Continuing pain and a clicking or locking with knee movement are other symptoms of torn menisci. Once the menisci are torn, the knee may buckle or lock without warning. Wearing a brace during activity can help protect the knee from further injury, but surgery may be needed to remove pieces of torn menisci. Joint Mice Iliotibial Band Syndrome Iliotibial band syndrome is pain experienced during activity, such as running or an exercise routine. The iliotibial band is made up of a muscle that begins at the top rim of the pelvis and a tendon that fits into the outside of the knee. Exercise can cause the band to tighten or partially tear. The pain usually begins 10 to 20 minutes into a run or other exercise routine and stops when the activity stops. Iliotibial band syndrome often grows worse, with pain increasing and starting sooner during a workout. Caring for Knee Pain For mild sprains:
  • Follow the RICE method, and take medication for pain and swelling.

57. Knee Pain (Anterior) Referral Guideline
knee pain localized to the anterior portion of the knee, Patient education (refer patient to PT for Retropatellar pain syndrome (RPPS) Class).
http://www.mamc.amedd.army.mil/referral/guidelines/ortho_kneeant.htm
Acute Low Back Pain Carpal Tunnel Syndrome Cervical Pain/Stiffness de Quervain's Syndrome ... Ganglions Knee Pain (Anterior) Knee Pain (Traumatic) Mallet Finger Shoulder Dislocation Shoulder Pain (Adult) ... MAMC Intranet or WRMC Internet Referral Guidelines Guideline Updated: November 2002 Specialty: Orthopedics, Physical Therapy
Knee Pain (Anterior) Referral Guideline
Please also see the Knee Clinical Standard
Diagnosis/Definition
  • Knee pain localized to the anterior portion of the knee, either retropatellar or peripatellar. Usually a gradual, non-traumatic onset aggravated with increased activity, running, squatting, stair climbing, or prolonged sitting. Symptoms normally decrease with rest.
Initial Diagnosis and Management
  • History and physical examination. Plain films not required. NSAIDs. Avoidance of aggravating activities; profile for active duty soldiers.

58. Simon Bartold Podiatry:Anterior Knee Pain- Patello - Femoral Syndrome
anterior knee pain or knee pain arising from the front region of the knee is one of the most common injuries seen in sports medicine, arising from both the
http://www.simonbartoldpodiatry.com.au/fact_sheets/anterior_knee.html
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Anterior Knee Pain- Patello - Femoral Syndrome
The structures most commonly affected are the undersurface of the kneecap (or patella) and the end of the femur or thigh bone which forms a groove in which the patella slides. There may also be some inflammation of the patella tendon which is the attachment point of the quadricep muscles and the kneecap is incorporated in this tendon. These problems can exist individually or may present together.
Patello - femoral Syndrome
Predisposing factors for this condition include tight muscles (quadriceps , hamstrings and iliotibial band), internal rotated femur and tibia which is often secondary to excessive pronation of the foot and poor postural stability at the level of the hips and pelvis. Training changes such as increased workload, intensity or slope can also have an effect on the knee. Quadricep muscle weakness also upsets the balance of forces around the knee joint. Clinically the patient often presents with a vague ache, often aggravated by activity and may have some degree of swelling, creaking/grinding behind the kneecap. Some people will have pain after periods of rest especially sitting. It is important to have the injury correctly diagnosed to rule out more serious structural damage and to accurately determine which factors are contributing to the ongoing problem.

59. INTRODUCTION & DEFINITION
anterior knee pain (AKP) is a nonspecific diagnosis that refers to pain expressed pain syndrome, chondromalacia patellae , recalcitrant anterior knee
http://www.ucalgary.ca/~kneepain/Intro.htm
Anterior Knee Pain (AKP) is a nonspecific diagnosis that refers to pain expressed in the anterior region of the knee. It is a common clinical problem seen in all age groups and presented to general practice, sport medicine, orthopaedic and emergency department settings. Previous studies by our research group have confirmed that a paucity of consensus exists in the following areas definition classification , assessment, diagnosis and management of anterior knee pain. This lack of consensus and the ambiguity of the term 'anterior knee pain' creates confusion and frustration for both the clinician and the patient. Anterior Knee Pain has been referred to as any one of ' patellofemoral pain syndrome chondromalacia patellae recalcitrant anterior knee pain patellofemoral stress syndrome femoropatellar pain syndrome patellofemoral arthralgia ' or ' patellalgia '. Without consensus on the definition, etiology and/or management of anterior knee pain, a symptom such as pain in the anterior region of the knee becomes accepted as a diagnosis. The treatment process then results in a subjective focus on the symptoms rather than individualizing treatment based upon causative and/or etiologic factors. The use of consensus statements in the assessment and management of knee disorders may assist in alleviating the confusion for patients and physicians, and may result in more efficient use of health care dollars. The AKP research group is undergoing a multi-phased approach to developing consensus statements in the areas of definition, assessment, diagnosis and management. Consensus that is based upon current scientific literature coupled with 'expert' opinion and review assists in providing a strong foundation for developing clinical guidelines.

60. Knee Pain
Runners knee (also called patellofemoral pain or anterior knee pain) is a common Runners knee / Patellofemoral pain syndrome Common knee condition that
http://www.knee-pain-management.com/
Knee Pain
Common Causes, Treatments, and Prevention of Knee Pain Knee Pain Overview MAIN MENU Home Page Knee Exercises Knee-Safe Aerobics Knee Anatomy ... TENS SITE RESOURCES If you have a website related to knee pain, submit your site to us for possible listing on our partner site directory. Share this site by pasting this code on your site. Visit our partner sites Please read our terms of use and privacy policy pages.
KNEE PAIN OVERVIEW
If you are suffering from knee pain, see a doctor / orthopedic surgeon who can determine the cause and prescribe an appropriate treatment and pain management plan. This site covers only the more common types of knee pain. It will familiarize you with various causes, treatments, and prevention of knee pain, but please do not attempt to diagnose yourself. The knees are the most easily injured part of the body.

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