Infrapatellar plica of the knee: revisited with MR arthrographies undertaken in the knee flexion position mimicking operative arthroscopic posture.

PURPOSE

To describe the appearance of the infrapatellar plica (IPP) on magnetic resonance arthrography (MRA) taken in 70° knee flexion, corresponding to the arthroscopic posture.

MATERIALS AND METHODS

Twenty-two patients (23 knee joints) who underwent MRA with 70° knee flexion were enrolled. All patients underwent MRA with 70° knee flexion to simulate operative arthroscopy. The images included fat-suppressed T1-weighted spin echo axial, sagittal, and coronal images. The visualization and morphology of the IPP were retrospectively assessed by two musculoskeletal radiologists.

RESULTS

The IPP was demonstrated in 78.3% (n=18/23) and was best visualized on the sagittal section through the intercondylar notch. The IPP manifested as a linear hypointense structure with variable thicknesses. The intercondylar component was delineated clearly, arising from the anterior intercondylar notch in parallel with the ACL and curving gently downward to attach to the infrapatellar fat pad. On the other hand, the Hoffa's fat pad component was not depicted clearly. The morphology of the IPP was either a separate type (60.9%) or a split type (17.4%).

CONCLUSION

The IPPs can be visualized with a high rate of detection and various morphologic appearances must be appreciated under the review of a flexed knee MRA.