MR Imaging of Extrasynovial Inflammation and Impingement About the Knee

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Key points

  • The knee has unique anatomy regarding the relationship between the synovial and capsular layers, with interposed fat pads at certain locations.

  • The extrasynovial impingement and inflammation syndromes about the knee are underdiagnosed and should be included in the differential diagnosis of anterior knee pain.

  • MR imaging is the best imaging modality for evaluation of the anatomy and disorders of these extrasynovial compartments.

Summary

The fat pads of the knee are of great importance and are the main structures of the extrasynovial compartment. They have been underappreciated in the literature. The fat pads should be recognized as more than passive, space-occupying structures: they serve to protect the knee by remodeling their shape to adapt to the various degrees of flexion and assist in preserving the compartments of the knee joint by modulating direct contact.6 Fat pads are richly vascularized and innervated, functioning

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    E.Y. Chang, MD, gratefully acknowledges grant support from the VA (Clinical Science Research and Development Career Development Award: 1IK2CX000749).

    Conflicts of Interest: None.

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