Recesses along the posterior margin of the infrapatellar (Hoffa’s) fat pad: prevalence and morphology on routine MR imaging of the knee

The objective is to evaluate the prevalence and morphology of recesses along the posterior margin of the infrapatellar fat pad on routine MR imaging of the knee. MR images of 213 knees in 204 consecutive individuals were evaluated with regard to the prevalence and morphology of recesses (a “suprahoffatic” recess close to the inferior border of the patella and the previously described “infrahoffatic” recess anterior to the inferior portion of the infrapatellar plica). The recesses were analyzed with regard to synovial effusion and the condition of the anterior cruciate ligament (ACL). Anatomic dissection was made in 29 knees in 16 cadavers to verify the presence of the suprahoffatic recess. The infrahoffatic recess was present in 45% of the knees and mostly linear in shape (44%). The suprahoffatic recess was detected in 71% of the knees (45% in cadavers). Very weak to moderate positive correlation was found between the synovial effusion or the condition of the ACL and the presence and dimensions of the recesses. An awareness of the recesses in the infrapatellar fat pad is important in order to distinguish between pathology and anatomic variants on routine MR imaging of the knee.