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PFP patients showed alterations in proximal and distal muscle thickness, despite the lack of association with poor lower limb alignment. Prospective studies are necessary to determine if differences in muscle morphology are the cause or the consequence of PFP and to confirm the absence of relationship with lower limb alignment. PFP patients showed alterations in proximal and distal muscle thickness, despite the lack of association with poor lower limb alignment. Prospective studies are necessary to determine if differences in muscle mor