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Imaging of traumatic injury and impingement of anterior knee fat

Abstract Fat is not just used by the body as bulk tissue. In addition to its role in storing energy and regulating hormone action, fat is used in some parts of the body for its mechanical properties. The anatomy of anterior knee fat is more complex than it appears at first sight and is capable of wi...

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Published in:Diagnostic and interventional imaging 2016-07, Vol.97 (7-8), p.789-807
Main Authors: Lapègue, F, Sans, N, Brun, C, Bakouche, S, Brucher, N, Cambon, Z, Chiavassa, H, Larbi, A, Faruch, M
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description Abstract Fat is not just used by the body as bulk tissue. In addition to its role in storing energy and regulating hormone action, fat is used in some parts of the body for its mechanical properties. The anatomy of anterior knee fat is more complex than it appears at first sight and is capable of withstanding considerable compressive and shear stress. Specific lesions occur when such mechanical stress exceeds the physiological limits and are yet little known. Superficial fat can be the site of either acute injury by closed degloving called the Morel-Lavallée lesion or chronic injury, when subject to repeat excessive shear forces, due to more complex and less well-defined disruptions that result in pseudo-bursitis. There are three main anterior, intracapsular and extrasynovial fat pads in the knee joint, which are the infrapatellar fat pad (IFP) or Hoffa's fat pad, the quadriceps fat pad and the prefemoral fat pad. The IFP plays an important role as a mechanical shock absorber and guides the patella tendon and even the patella itself during flexion–extension movements. In response to repeated excessive stress, an inflammatory reaction and swelling of the IFP is first observed, followed by a fibrotic reaction with metaplastic transformation into fibrous, cartilaginous or bone tissue. More rarely, the two other deep fat pads (quadriceps and prefemoral) can, if subject to repeated stress, undergo similar restructuring inflammatory reactions with metaplasia resulting in tissue hardening, anterior pain and partial loss of function.
doi_str_mv 10.1016/j.diii.2016.02.012
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In addition to its role in storing energy and regulating hormone action, fat is used in some parts of the body for its mechanical properties. The anatomy of anterior knee fat is more complex than it appears at first sight and is capable of withstanding considerable compressive and shear stress. Specific lesions occur when such mechanical stress exceeds the physiological limits and are yet little known. Superficial fat can be the site of either acute injury by closed degloving called the Morel-Lavallée lesion or chronic injury, when subject to repeat excessive shear forces, due to more complex and less well-defined disruptions that result in pseudo-bursitis. There are three main anterior, intracapsular and extrasynovial fat pads in the knee joint, which are the infrapatellar fat pad (IFP) or Hoffa's fat pad, the quadriceps fat pad and the prefemoral fat pad. The IFP plays an important role as a mechanical shock absorber and guides the patella tendon and even the patella itself during flexion–extension movements. In response to repeated excessive stress, an inflammatory reaction and swelling of the IFP is first observed, followed by a fibrotic reaction with metaplastic transformation into fibrous, cartilaginous or bone tissue. More rarely, the two other deep fat pads (quadriceps and prefemoral) can, if subject to repeated stress, undergo similar restructuring inflammatory reactions with metaplasia resulting in tissue hardening, anterior pain and partial loss of function.</description><identifier>ISSN: 2211-5684</identifier><identifier>EISSN: 2211-5684</identifier><identifier>DOI: 10.1016/j.diii.2016.02.012</identifier><identifier>PMID: 27118690</identifier><language>eng</language><publisher>France: Elsevier Masson SAS</publisher><subject>Adipose Tissue - diagnostic imaging ; Adipose Tissue - injuries ; Bursitis ; Bursitis - diagnostic imaging ; Fat pad ; Friction - physiology ; Hoffa's syndrome ; Humans ; Knee ; Knee Injuries - diagnostic imaging ; Knee Joint - anatomy &amp; histology ; Knee Joint - diagnostic imaging ; Morel-Lavallée lesion ; Patellar Ligament - diagnostic imaging ; Patellar Ligament - physiopathology ; Radiology ; Sprains and Strains - diagnostic imaging ; Subcutaneous Fat - diagnostic imaging ; Subcutaneous Fat - injuries ; Synovitis - diagnostic imaging</subject><ispartof>Diagnostic and interventional imaging, 2016-07, Vol.97 (7-8), p.789-807</ispartof><rights>Éditions françaises de radiologie</rights><rights>2016 Editions françaises de radiologie</rights><rights>Copyright © 2016 Editions françaises de radiologie. 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In addition to its role in storing energy and regulating hormone action, fat is used in some parts of the body for its mechanical properties. The anatomy of anterior knee fat is more complex than it appears at first sight and is capable of withstanding considerable compressive and shear stress. Specific lesions occur when such mechanical stress exceeds the physiological limits and are yet little known. Superficial fat can be the site of either acute injury by closed degloving called the Morel-Lavallée lesion or chronic injury, when subject to repeat excessive shear forces, due to more complex and less well-defined disruptions that result in pseudo-bursitis. There are three main anterior, intracapsular and extrasynovial fat pads in the knee joint, which are the infrapatellar fat pad (IFP) or Hoffa's fat pad, the quadriceps fat pad and the prefemoral fat pad. 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More rarely, the two other deep fat pads (quadriceps and prefemoral) can, if subject to repeated stress, undergo similar restructuring inflammatory reactions with metaplasia resulting in tissue hardening, anterior pain and partial loss of function.</description><subject>Adipose Tissue - diagnostic imaging</subject><subject>Adipose Tissue - injuries</subject><subject>Bursitis</subject><subject>Bursitis - diagnostic imaging</subject><subject>Fat pad</subject><subject>Friction - physiology</subject><subject>Hoffa's syndrome</subject><subject>Humans</subject><subject>Knee</subject><subject>Knee Injuries - diagnostic imaging</subject><subject>Knee Joint - anatomy &amp; histology</subject><subject>Knee Joint - diagnostic imaging</subject><subject>Morel-Lavallée lesion</subject><subject>Patellar Ligament - diagnostic imaging</subject><subject>Patellar Ligament - physiopathology</subject><subject>Radiology</subject><subject>Sprains and Strains - diagnostic imaging</subject><subject>Subcutaneous Fat - diagnostic imaging</subject><subject>Subcutaneous Fat - injuries</subject><subject>Synovitis - diagnostic imaging</subject><issn>2211-5684</issn><issn>2211-5684</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><recordid>eNp9kU9LxDAQxYMoKuoX8CA9etmaSdJsCiKK-A8ED3oPaTqV1DZdk1bYb2_KqogHc0gG8t5j5jeEHAPNgYI8a_PaOZezVOeU5RTYFtlnDGBRSCW2f9V75CjGlqYjk1iIXbLHlgBKlnSfXD705tX512xosjGYqTejs5nz7RTWmfF15vpV-sYe_ThrjB8xuCFkbx4xa8x4SHYa00U8-noPyMvtzcv1_eLx6e7h-upxYQsG46LmDeVUcIu2wMrKslxWPF2lEVYiT33WlWJCMEmFUmYpFC_KqoJGGtWA5AfkdBO7CsP7hHHUvYsWu854HKaoQdEyjQeUJynbSG0YYgzY6FVwvQlrDVTP7HSrZ3Z6Zqcp04ldMp185U9Vj_WP5ZtUEpxvBJiG_HAYdLQOvcXaBbSjrgf3f_7FH7vtnHfWdG-4xtgOU_AJnwYdk0E_z9ublwcy7U0VwD8BqWSSxA</recordid><startdate>20160701</startdate><enddate>20160701</enddate><creator>Lapègue, F</creator><creator>Sans, N</creator><creator>Brun, C</creator><creator>Bakouche, S</creator><creator>Brucher, N</creator><creator>Cambon, Z</creator><creator>Chiavassa, H</creator><creator>Larbi, A</creator><creator>Faruch, M</creator><general>Elsevier Masson SAS</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20160701</creationdate><title>Imaging of traumatic injury and impingement of anterior knee fat</title><author>Lapègue, F ; 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In addition to its role in storing energy and regulating hormone action, fat is used in some parts of the body for its mechanical properties. The anatomy of anterior knee fat is more complex than it appears at first sight and is capable of withstanding considerable compressive and shear stress. Specific lesions occur when such mechanical stress exceeds the physiological limits and are yet little known. Superficial fat can be the site of either acute injury by closed degloving called the Morel-Lavallée lesion or chronic injury, when subject to repeat excessive shear forces, due to more complex and less well-defined disruptions that result in pseudo-bursitis. There are three main anterior, intracapsular and extrasynovial fat pads in the knee joint, which are the infrapatellar fat pad (IFP) or Hoffa's fat pad, the quadriceps fat pad and the prefemoral fat pad. The IFP plays an important role as a mechanical shock absorber and guides the patella tendon and even the patella itself during flexion–extension movements. In response to repeated excessive stress, an inflammatory reaction and swelling of the IFP is first observed, followed by a fibrotic reaction with metaplastic transformation into fibrous, cartilaginous or bone tissue. More rarely, the two other deep fat pads (quadriceps and prefemoral) can, if subject to repeated stress, undergo similar restructuring inflammatory reactions with metaplasia resulting in tissue hardening, anterior pain and partial loss of function.</abstract><cop>France</cop><pub>Elsevier Masson SAS</pub><pmid>27118690</pmid><doi>10.1016/j.diii.2016.02.012</doi><tpages>19</tpages><oa>free_for_read</oa></addata></record>
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subjects Adipose Tissue - diagnostic imaging
Adipose Tissue - injuries
Bursitis
Bursitis - diagnostic imaging
Fat pad
Friction - physiology
Hoffa's syndrome
Humans
Knee
Knee Injuries - diagnostic imaging
Knee Joint - anatomy & histology
Knee Joint - diagnostic imaging
Morel-Lavallée lesion
Patellar Ligament - diagnostic imaging
Patellar Ligament - physiopathology
Radiology
Sprains and Strains - diagnostic imaging
Subcutaneous Fat - diagnostic imaging
Subcutaneous Fat - injuries
Synovitis - diagnostic imaging
title Imaging of traumatic injury and impingement of anterior knee fat
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