Abstract
A variety of intrinsic and extrinsic tumours and tumour-like conditions may affect the infrapatellar (Hoffa’s) fat pad (IFP). MR imaging is the technique of choice in evaluating these conditions, but correlation with radiographs is important to identify those lesions producing mineralization. This pictorial review illustrates the spectrum of mass-like lesions that can affect the IFP, emphasizing the radiographic and MR findings that suggest a specific diagnosis.
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Jacobson JA, Lenchik L, Ruboy MK, Schweitzer ME, Resnick D (1997) MR imaging of the infrapatellar fat pad of Hoffa. Radiographics 17:675–691
González-Lois C, García-de-la-Torre P, SantosBriz-Terrón A, Vilá J, Manrique-Chico J, Martínez-Tello J (2001) Intracapsular and para-articular chondroma adjacent to large joints: report of three cases and review of the literature. Skeletal Radiol 30:672–676
Bansal M, Goldman AB, DiCarlo EF, McCormack R (1993) Soft tissue chondromas: diagnosis and differential diagnosis. Skeletal Radiol 22:309–315
Kransdorf MJ, Meis JM (1993) From the archives of the AFIP. Extraskeletal osseous and cartilaginous tumors of the extremities. Radiographics 13:853–884
Zlatkin MB, Lander PH, Begin LR, Hadjipavlou A (1985) Soft tissue chondromas. Am J Roentgenol 144:1263–1267
Sakai H, Tamai K, Iwamoto A, Saotome K (1999) Para-articular chondroma and osteochondroma of the infrapatellar fat pad: a report of three cases. Int Orthop 23:114–117
Steiner GC, Meushar N, Norman A, Present D (1994) Intracapsular and paraarticular chondromas. Clin Orthop 303:231–236
Schmidt-Rohlfing B, Staatz G, Tietze L, Ihme N, Siebert CH, Niethard FU (2002) Diagnosis and differential diagnosis of extraskeletal, para-articular chondroma of the knee. Z Orthop 140:544–547
Kudawara I, Ueda T, Araki N (2001) Extraskeletal chondroma around the knee. Clin Radiol 56:779–782
Cohen AP, Giannoudis PV, Hinsche A, Smith RM, Matthews SJE (2001) Post-traumatic giant intra-articular synovial osteochondroma of the knee. Injury 32:87–89
Matsumoto H, Kawakubo M, Otani T, Fujikawa K (1999) Extensive post-traumatic ossification of the patellar tendon. A report of two cases. J Bone Joint Surg Br 81:34–36
Mundy GM, Oni OOA (2003) Patellar tendon ossification treated with simple subcapsular excision. J Knee Surg 16:221–223
Masih S, Antebi A (2003) Imaging of pigmented villonodular synovitis. Semin Musculoskelet Radiol 7:205–216
Moskovich R, Parisien JS (1991) Localized pigmented villonodular synovitis of the knee. Arthroscopic treatment. Clin Orthop 271:218–224
Palumbo RC, Matthews LS, Reuben JM (1994) Localized pigmented villonodular synovitis of the patellar fat pad: a report of two cases. Arthroscopy 10:400–403
Musculo DL, Makino A, Costa-Paz M, Ayerza MA (1995) Localized pigmented villonodular synovitis of the posterior compartment of the knee: diagnosis with magnetic resonance imaging. Arthroscopy 11:482–485
Otsuka Y, Mizuta H, Nakamura E, Kudo S, Inoue S, Takagi K (1996) Tenosynovial giant-cell tumor arising from the anterior cruciate ligament of the knee. Arthroscopy 12:496–499
Williams AM, Myers PT (1997) Localized pigmented villonodular synovitis: a rare cause of locking of the knee. Arthroscopy 13:515–516
Lee BI, Yoo JE, Lee SH, Min KD (1998) Localized pigmented villonodular synovitis of the knee: arthroscopic treatment. Arthroscopy 14:764–768
Mancini GB, Lazzeri S, Bruno G, Pucci G (1998) Localized pigmented villonodular synovitis of the knee. Arthroscopy 14:532–536
Delcogliano A, Galli M, Menghi A, Belli P (1998) Localized pigmented villonodular synovitis of the knee: report of two cases of fat pad involvement. Arthroscopy 14:527–531
De Visser E, Veth RP, Pruszczynski M, Wobbes T, Van de Putte LB (1999) Diffuse and localized pigmented villonodular synovitis: evaluation of treatment of 38 patients. Arch Orthop Trauma Surg 119:401–404
Bartlett MJ, Lavelle J (2000) Localized pigmented villo-nodular synovitis presenting as recurrent dislocation of the patella. Arthroscopy 16:767–769
Choi NH (2000) Localized pigmented villonodular synovitis involving the fat pad of the knee: case report. Am J Knee Surg 13:117–119
Kim SJ, Shin SJ, Choi NH, Choo ET (2000) Arthroscopic treatment for localized pigmented villonodular synovitis of the knee. Clin Orthop 379:224–230
Muscolo DL, Makino A, Cost-Paz M, Ayerza M (2000) Magnetic resonance imaging evaluation and arthroscopic resection of localized pigmented villonodular synovitis of the knee. Orthopedics 23:367–369
Akgün I, Ögüt T, Kesmezacar H, Dervisoglu S (2003) Localized pigmented villonodular synovitis of the knee. Orthopedics 26:1131–1135
Khanduja V, Dannawi Z, Ng L, El-Zebdeh M (2004) Giant cell tumor of the tendon sheath arising from the patellar tendon: case report. J Knee Surg 17:28–29
Bernstein AD, Jazrawi LM, Rose DJ (2001) Arthroscopic treatment of an intra-articular lipoma of the knee joint. Arthroscopy 17:539–541
Matsumoto K, Okabe H, Ishizawa M, Hiraoka S (2001) Intra-articular lipoma of the knee joint: a case report. J Bone Joint Surg Am 83A:101–105
Yeomans NP, Robertson A, Calder SJ (2003) Torsion of an intra-articular lipoma as a cause of pseudo-locking of the knee. Arthroscopy 19:E27
Yamaguchi S, Yamamoto T, Matsushimata S, Yoshiya S, Matsubara N, Matsumoto T (2003) Solitary intraarticular lipoma causing sudden locking of the knee: a case report and review of the literature. Am J Sports Med 31:297–299
Pudlowski RM, Gilula LA, Kyriakos M (1979) Intraarticular lipoma with osseous metaplasia: radiographic-pathologic correlation. Am J Roentgenol 132:471–473
Marui T, Yamamoto T, Kimura T et al (2002) A true intra-articular lipoma of the knee in a girl. Arthroscopy 18:E24
Ryu KN, Jaovisidha S, Schweitzer M (1996) MR imaging of lipoma arborescens of the knee joint. Am J Roentgenol 167:1229–1232
Soler T, Rodríguez E, Bargiela A, Da Riba M (1998) Lipoma arborescens of the knee: MR characteristics in 13 joints. J Comput Assist Tomogr 22:605–609
Narváez JA, Narváez J, Aguilera C, De Lama E, Portabella F (2001) MR imaging of synovial tumors and tumor-like lesions. Eur Radiol 11:2549–2560
Khan AM, Cannon S, Levack B (2003) Primary intra-articular liposarcoma of the knee: case report. J Knee Surg 16:107–109
Robertson PL, Schweitzer ME, Bartolozzi AR, Ugoni A (1994) Anterior cruciate ligament tears: evaluation of multiple signs with MR imaging. Radiology 193:829–834
Apostolaki E, Cassar-Pullicino VN, Tyrrell PNM, McCall IW (1999) MRI appearances of the infrapatellar fat pad in occult traumatic patellar dislocation. Clin Radiol 54:743–747
Hoffa A (1904) Influence of adipose tissue with regard to the pathology of the knee joint. J Am Med Assoc 43:795–796
Olgilvie-Harris DJ, Giddens J (1994) Hoffa’s disease: arthroscopic resection of the infrapatellar fat pad. Arthroscopy 10:184–187
Magi M, Branca A, Bucca C, Langerame V (1991) Hoffa’s disease. Ital J Orthop Trauma 17:211–216
Krebs VE, Parker RD (1994) Arthroscopic resection of an extrasynovial ossifying chondroma of the infrapatellar fat pad. End-stage Hoffa’s disease? Arthroscopy 10:301–304
Tang G, Nitsu M, Ikeda K, Endo H, Itai Y (2000) Fibrous scar in the infrapatellar fat pad after arthroscopy. Radiat Med 18:1–5
Recht MP, Piraino DW, Cohen MAH, Parker RD, Bergfield JA (1995) Localized anterior arthrofibrosis (cyclops lesion) after reconstruction of the anterior cruciate ligament: MR imaging findings. Am J Roentgenol 165:383–385
Bradley DM, Bergman AG, Dillingham MF (2000) MR imaging of cyclops lesions. Am J Roentgenol 174:719–726
McMahon PJ, Dettinger JR, Yocum LA, Glousman RE (1999) The cyclops lesion: a cause of diminished knee extension after rupture of the anterior cruciate ligament. Arthroscopy 15:757–761
Huang GS, Lee CH, Chan WP, Lee HJ, Chen CY, Yu JS (2002) Acute anterior cruciate ligament stump entrapment in anterior cruciate ligament tears. Radiology 225:537–540
Chung CB, Skaf A, Roger B, Campos J, Stump X, Resnick D (2001) Patellar tendon-lateral femoral condyle friction syndrome: MR imaging in 42 patients. Skeletal Radiol 30:694–697
Kramer J, Recht M, Deely DM, Schweitzer M, Pathria MN, Gentili A, Greenway G, Resnick D (1993) MR appearance of idiopathic synovial chondromatosis. J Comput Assist Tomogr 17:772–776
Wittkop B, Davies AM, Mangham DC (2002) Primary synovial chondromatosis and synovial chondrosarcoma: a pictorial review. Eur Radiol 12:2112–2119
Bertoni F, Unni KK, Beabout JW, Sim FH (1991) Chondrosarcoma of the synovium. Cancer 67:155–162
Kenan S, Abdelwahab IF, Klein MJ, Lewis MM (1993) Case report 817: synovial chondrosarcoma secondary to synovial chondromatosis. Skeletal Radiol 22:623–626
Moon NE (1973) Synovial hemangioma of the knee joint. A review of previously reported cases and inclusion of two new cases. Clin Orthop 90:183–190
Devaney K, Vinh TN, Sweet DE (1993) Synovial hemangioma: a report of 20 cases with differential diagnostic considerations. Hum Pathol 24:737–745
Price NJ, Cundy PJ (1997) Synovial hemangioma of the knee. J Pediatr Orthop 17:74–77
Lenchik L, Poznanski AK, Donaldson JS, Sarwark JF (1991) Case report 681: synovial hemangioma of the knee. Skeletal Radiol 20:387–389
Llauger J, Monill JM, Palmer J, Clotet M (1995) Synovial hemangioma of the knee: MRI findings in two cases. Skeletal Radiol 24:579–581
Hawley WL, Ansell BM (1981) Synovial hemangioma presenting as monarticular arthritis of the knee. Arch Dis Child 56:558–560
Ryd L, Stenström A (1989) Hemangioma mimicking meniscal injury. A report on 10 years of knee pain. Acta Orthop Scand 60:230–231
Shapiro GS, Fanton GS (1993) Intraarticular hemangioma of the knee. Arthroscopy 9:464–466
Pinar H, Bozkurt M, Baktiroglu L, Karaoglan O (1997) Intra-articular hemangioma of the knee. Arthroscopy 13:507–510
Petersen W, Rafii M, Ellwanger S, Laprell H (1999) Synovialhämangiom innerhalb des Hoffa’schen Fettkörpers als Ursache für vorderen Knieschmerz. Z Orthop 137:376–378
Aynaci O, Ahmetoglu A, Reis A, Turhan AU (2001) Synovial hemangioma in Hoffa’s fat pad (case report). Knee Surg Sports Traumatol Arthrosc 9:355–357
Cotton A, Flippo RM, Herbaux B, Gougeon F, Lecomte-Houcke M, Chastenet P (1995) Synovial haemangioma of the knee: a frequently misdiagnosed lesion. Skeletal Radiol 24:257–261
Wong K, Sallomi D, Janzen DL, Munk PL, O’Connell JX, Lee MJ (1999) Monoarticular synovial lesions: radiologic pictorial essay with pathologic illustration. Clin Radiol 54:273–284
Greenspan A, Azouz EM, Mathews J, Decarie JC (1995) Synovial haemangioma: imaging features in eight histologically proven cases, review of the literature, and differential diagnosis. Skeletal Radiol 24:583–590
Comert RB, Aydingoz U, Atay OA, Gedikoglu G, Doral MN (2004) Vascular malformation in the infrapatellar (Hoffa’s) fat pad: case report. Knee 11:137–140
Schweitzer ME, Falk A, Berthoty D, Mitchell M, Resnick D (1992) Knee effusion: normal distribution of fluid. Am J Roentgenol 159:361–363
Schweitzer ME, Falk A, Pathria M, Brahme S, Hodler J, Resnick D (1993) MR imaging of the knee: can changes in the intracapsular fat pads be used as a sign of synovial proliferation in the presence of an effusion? Am J Roentgenol 160:823–826
Patel SJ, Kaplan PA, Dussault RG, Kahler DM (1998) Anatomy and clinical significance of the horizontal cleft in the infrapatellar fat pad of the knee: MR imaging. Am J Roentgenol 170:1551–1555
Vahlensieck M, Linneborn G, Schild HH, Schmidt HM (2002) Hoffa’s recess: incidence, morphology and differential diagnosis of the globular-shaped cleft in the infrapatellar fat pad of the knee on MRI and cadaver dissections. Eur Radiol 12:90–93
Bui-Mansfield LT, Youngberg RA (1997) Intraarticular ganglia of the knee: prevalence, presentation, etiology, and management. Am J Roentgenol 168:123–127
Kim MG, Kim BH, Choi JA, Lee NJ, Chung KB, Choi YS, Cho SB, Lim HC (2001) Intra-articular ganglion cysts of the knee: clinical and MR features. Eur Radiol 11:834–840
Janzen DL, Peterfy CG, Forbes JR, Tirman PF, Genant HK (1994) Cystic lesions around the knee joint: MR imaging findings. Am J Roentgenol 163:155–161
Steiner E, Steinbach LS, Schnarkowski P, Tirman PF, Genant HK (1996) Ganglia and cysts around joints. Radiol Clin North Am 34:395–425 (xi–xii)
Morrison JL, Kaplan PA (2000) Water on the knee: cysts, bursae and recesses. Magn Reson Imaging Clin N Am 8:349–370
Tyrrell PNM, Cassar-Pullcino VN, McCall IW (2000) Intra-articular ganglion cyst of the cruciate ligaments. Eur Radiol 10:1233–1238
Stacy GS, Heck RK, Peabody TD, Dixon LB (2002) Neoplastic and tumorlike lesions detected on MR imaging of the knee in patients with suspected internal derangement. Part 2. Articular and juxtaarticular entities. Am J Roentgenol 178:595–599
Zantop T, Rusch A, Hassenpflug J, Petersen W (2003) Intra-articular ganglion cysts of the cruciate ligaments: case report and review of the literature. Arch Orthop Trauma Surg 123:195–198
Franceschi F, Rizzello G, Maffei MV, Papalia R, Denaro V (2003) Arthroscopic ganglion cyst excision in the anterolateral aspect of the knee. Arthroscopy 19:E32
Gebhardt MC, Parekh SG, Rosenberg AE, Rosenthal DI (1999) Extraskeletal myxoid chondrosarcoma of the knee. Skeletal Radiol 28:354–358
Hur J, Damron TA, Vermont AI, Mathur SC (1999) Fibroma of tendon sheath of the infrapatellar fat pad. Skeletal Radiol 28:407–410
Pinar H, Ozkan M, Ozaksoy D, Pabuccuoglu U, Akseki D, Karaoglan O (1995) Intraarticular fibroma of the tendon sheath of the knee. Arthroscopy 11:608–611
Hardy P, Muller GP, Got C, Lortat-Jacob A, Benoit J (1998) Glomus tumor of the fat pad. Arthroscopy 14:325–328
Van Slyke MA, Moser RP, Madewell JE (1995) MR imaging of periarticular soft tissue lesions. Magn Reson Imaging Clin N Am 3:651–667
Llauger J, Palmer J, Rosón N, Bagué S, Camins A, Cremades R (2000) Nonseptic monoarthritis: imaging features with clinical and histopathologic correlation. Radiographics 20:S263–S278
Narváez JA, Narváez J, Ortega R, De Lama E, Roca Y, Vidal N (2003) Hypointense synovial lesions on T2-weighted images: differential diagnosis with pathologic correlation. Am J Roentgenol 181:761–769
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Helpert, C., Davies, A.M., Evans, N. et al. Differential diagnosis of tumours and tumour-like lesions of the infrapatellar (Hoffa’s) fat pad: pictorial review with an emphasis on MR imaging. Eur Radiol 14, 2337–2346 (2004). https://doi.org/10.1007/s00330-004-2491-1
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DOI: https://doi.org/10.1007/s00330-004-2491-1