(Fig 4-C.13) Posterior Hoffa's Fat Pad Impingement, Plica syndrome

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https://youtu.be/EiNzQqJbmYs

 

 

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📌 Posterior Hoffa's Fat Pad Impingement (Infrapatellar Plica Syndrome)

 

• Posterior Hoffa's fat pad impingement, often associated with infrapatellar plica syndrome, is a condition marked by degeneration or fibrosis of the plica. 
• The infrapatellar plica can become thickened and fibrotic, which results in symptomatic anterior knee pain and restricted movement.
•  The primary mechanism involves impingement at the intercondylar notch and trochlea, causing significant discomfort and limited mobility.

 

✅ Imaging Findings

• MRI plays a crucial role in diagnosing this condition. 
• High signal on fat-suppressed PDW FSE or T2W FSE images along the expected course of the infrapatellar plica indicates the syndrome.
• Chondromalacia often occurs at the superior aspect of the intercondylar notch and on the patellofemoral sulcus.

 

✅ Symptoms and Diagnosis

• Plica syndrome is characterized by painful knee impairment with the only imaging finding being an abnormal plica. 
• It can be caused by direct injury, repetitive overuse, or various inflammatory conditions. 
• However, most cases are idiopathic. 
• The condition may overlap clinically and radiographically with Hoffa's disease, making it an exclusion diagnosis.

 

References

• Skeletal Radiology (2020) 49:823–836
• MRI Web Clinic — November 2018

 

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