A 48 year-old male patient presented to our clinic with lateral right knee snapping and pain that had been ongoing for over 2 years without trauma or other known cause. The patient noted the pain and snapping at the fibular head worsened with cycling and deep squats. On examination, no atrophy was noted, however snapping was visible at knee flexion past 90 degrees. The patient had attempted activity modification, a home-exercise program and icing without relief. Radiographs of the knee were unremarkable with no evidence of any osseous abnormalities or bony prominences at the fibular head. MRI imaging of the right knee did not indicate evidence of an anatomical variant or anomalous insertion of the biceps femoris tendon (Figure 1). After 8 weeks of physical therapy focused on knee conditioning and hamstring strengthening, the patient reported worsening of symptoms and elected to proceed with surgery since conservative options had been exhausted.