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Quadriceps Fat Pad Signal Intensity and Enlargement on MRI

Florence Nightingale Hospital Istanbul, Turkey

We were interested in the report of Roth et al. [1] in the June issue of the AJR, particularly because we have encountered patients with similar MRI findings for the past few years.

Our first patient was a 34-year-old man who was referred to our radiology department for knee MR examination. Physical examination revealed tenderness and pain in the suprapatellar area. Radiographs showed unremarkable findings. Knee MRI was performed and disclosed mass effect of the suprapatellar (quadriceps) fat pad with a convex posterior contour and high signal intensity on fat-saturated fast spin-echo proton density images. No other abnormality was detected. Pertinent MRI findings and physical signs and symptoms led us to administer an IV gadopentetate dimeglumine injection, and the contrast-enhanced images showed dense enhancement of the suprapatellar fat body.

In our practice, we have seen a total of 15 patients with 19 knees having similar findings. We performed contrast-enhanced MR examinations for each of the patients, and the MR images revealed similar bright enhancement after contrast injection in all patients. In four patients, CT-guided steroid injections were administered and their symptoms were abolished with no symptom recurrence in any of these four patients. Biopsy of the suprapatellar fat pad in a single patient showed findings consistent with myxoid degeneration, fibrosis, and inflammation.

In the anatomic study of extensor structures of the knee by Staeubli et al. [2], the anteroposterior distance of the suprapatellar fat body measured 6 mm in women and 7 mm in men. Roth et al. [1] reported similar measurements. Using a modified measurement technique, we obtained a mean value of 12.5 mm (range, 11–15 mm) in healthy subjects and 16 mm (range, 12–20 mm) in 19 knees of our 15 patients.

In conclusion, we agree with the statements made in the article by Roth et al. [1] and describe our findings to support the authors in their recognition of the suprapatellar fat pad abnormality in patients with anterior knee pain.

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1. Roth C, Jacobson J, Jamadar D, Caoili E, Morag Y, Housner J. Quadriceps fat pad signal intensity and enlargement on MRI: prevalence and associated findings. AJR2004; 182:1383 –1387[Abstract/Free Full Text]
2. Staeubli H-U, Bollmann C, Kreutz R, Becker W, Rauschning W. Quantification of intact quadriceps tendon, quadriceps tendon insertion, and suprapatellar fat pad: MR arthrography, anatomy, and cryosections in the sagittal plane. AJR1999; 173:691 –698[Abstract/Free Full Text]

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This Article Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Sirvanci, M. Articles by Ganiyusufoglu, A. K. Search for Related Content PubMed PubMed Citation Articles by Sirvanci, M. Articles by Ganiyusufoglu, A. K. Social Bookmarking                      What's this?