Moraux Antoine, Bianchi Stefano, Le Corroller Thomas
Imagerie Médicale Jacquemars Giélée, Lille, France.
Hôpital Privé la Louvière, Lille, France.
J Ultrasound Med. 2018 Jul;37(7):1821-1825. doi: 10.1002/jum.14508. Epub 2017 Dec 4.
We report on the imaging features of 6 soft tissue masses in the anterolateral aspect of the knee related to a focal defect of the lateral patellar retinaculum. In 4 patients (3 female and 1 male; 6-65 years) presenting with nontender palpable soft tissue masses in the anterolateral aspect of their knees, ultrasonography showed a focal defect of the lateral patellar retinaculum with herniation of the Hoffa fat pad, which was only visible in flexion. A magnetic resonance imaging examination performed in 1 case confirmed the defect in the lateral patellar retinaculum but did not show a mass, as the knee was examined only at 10° of flexion. The 2 remaining patients (one male and 1 female; 62 and 55 years) presented with soft tissue masses in their anterolateral knees in both flexion and extension. These masses were related respectively to a lipoma of the Hoffa fat pad and to a ganglion cyst, both herniated through a defect of the lateral patellar retinaculum. Our cases suggest that a focal defect of the lateral patellar retinaculum may be a route for Hoffa fat pad herniation as well as a route for superficial extension of infrapatellar fat lesions such as lipomas and ganglion cysts.
我们报告了6例与髌外侧支持带局灶性缺损相关的膝关节前外侧软组织肿块的影像学特征。4例患者（3例女性，1例男性；年龄6 - 65岁）膝关节前外侧出现可触及的无压痛软组织肿块，超声检查显示髌外侧支持带局灶性缺损，伴有Hoffa脂肪垫疝出，仅在膝关节屈曲时可见。1例患者进行的磁共振成像检查证实了髌外侧支持带缺损，但未显示肿块，因为该膝关节仅在屈曲10°时进行了检查。其余2例患者（1例男性和1例女性；年龄分别为62岁和55岁）膝关节前外侧在屈曲和伸直时均出现软组织肿块。这些肿块分别与Hoffa脂肪垫脂肪瘤和腱鞘囊肿有关，二者均通过髌外侧支持带缺损疝出。我们的病例表明，髌外侧支持带局灶性缺损可能是Hoffa脂肪垫疝出的途径，也是髌下脂肪病变（如脂肪瘤和腱鞘囊肿）向浅表延伸的途径。
