MRI OF FAT PAD IMPINGEMENT AROUND THE KNEE
There are four fat pads around the knee that can become impinged and can be symptomatic.
The four fat pads are:
- SupraTrochlear
- Quadriceps.
- Hoffa's fat pad.
- Pericruciate
Normal fat pads are High Signal on PD and will be dark on PDFS as they will completely fat saturate. When they are impinged, on MRI we look for high PDFS signal in these regions.
Image Above: Location for quadriceps fat pad (Blue Arrow), Supratrochlear Fat Pad (Pink arrow) and Hoffa's Fat Pad (yellow arrow). It will be dark on T2FS/PDFS as fat will saturate out.
On MRI Impingement of any of the fat pads has a similar appearance and the best sequence to diagnose it is on a STIR/T2FS or PDFS sequence.
Look for
- STIR/T2FS or PDFS : Increased signal
- T1: Low signal
- C+: There is no need to give contrast but if you do, impingement in the acute and subacute stages will enhance.
Image Above: Impingement of quadriceps fat pad ( yellow arrow). Due to swelling the posterior margin can become convex (blue arrow).
Image Above: Impingement of supratrochlear fat pad (yellow arrow). Same appearance as impingement elsewhere.
Image Above: Impingement of Hoffa's fat pad (yellow arrow).
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