✅ Knee MRI Mastery/Chap 4A. Patelloefemoral joint

(Fig 4-A.28) Displaced Osteochondral Fragments

MSK MRI 2024. 6. 4. 18:53

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📌Acute Patellar Dislocation and Loose Bodies

 

  • After an acute patellar dislocation, it's crucial to search for loose chondral or osteochondral fragments throughout the joint. 
  • These fragments often hide in specific knee recesses.

 

✅ Knee Recesses for Loose Bodies

  • Sub-popliteus Recess: Located between the popliteus tendon and the posterior horn of the lateral meniscus.
  • Posterior Capsular Recess: Found behind the PCL, extending from the medial femorotibial compartment.
  • Suprahoffatic Recess: At the superior part of Hoffa’s fat pad, near the inferior border of the patella.
  • Infrahoffatic Recess: Anterior to the lower portion of the infrapatellar plica (ligamentum mucosum).
  • Posterior Femoral Recesses (Subgastrocnemius Recesses): Behind the femoral condyles and gastrocnemius muscle heads.
  • Anterior Tibial Recess: Immediately anterior to the proximal tibia.
  • Central Synovial Recess: Between the patella/patellar ligaments and the anterior femur.
  • Parameniscal Recess: Above and below the lateral meniscus, in contact with the lateral femoral and tibial condyle.

 

✅ Characteristics of Loose Bodies

  • Fresh Chondral Loose Bodies: Retain the normal structure of articular cartilage.
  • Long-standing Chondral Bodies: Enlarge, become rounded, and may either float freely or embed in the synovial lining.
  • Osteochondral Loose Bodies: Show cartilage along with a piece of subchondral bone plate on imaging.

References

  1. Clin Sports Med. 2014 Jul;33(3):413-36.
  2. Semin Musculoskelet Radiol. 2021 Oct;25(5):690-699.
  3. Insights Imaging (2013) 4:257–272.

 

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#PatellarDislocation, #KneeRecesses, #OsteochondralLooseBodies, #ChondralLooseBodies, #HoffasFatPad, #MRI, #KneeAnatomy, #Orthopedics, #Radiology, #SportsMedicine