Edward B. Singleton Department of Radiology, Division of Body Imaging, Texas Children's Hospital and Baylor College of Medicine, Houston, TX, USA.
Department of Orthopedic Surgery, Texas Children's Hospital and Baylor College of Medicine, Houston, TX, USA.
Clin Imaging. 2023 Sep;101:161-166. doi: 10.1016/j.clinimag.2023.06.014. Epub 2023 Jun 23.
The presence of superolateral Hoffa's fat pad (SHFP) edema is associated with several morphometric measurements related to patellar alignment and trochlear morphology. Our aim is to evaluate management implications in adolescent patients with isolated superolateral Hoffa's fat pad edema on MRI.
Retrospective review of 117 adolescents with knee MRI (mean 14.8 years old) with isolated superolateral Hoffa's fat pad edema. Patients with edema were separated into two groups based on the number of MRI axial slices involved with edema: group 1 (G1) of 27 patients with 1 slice vs group 2 (G2) of 90 patients with 2 or more slices. A comparison control group was used (45 patients who had normal MRI knees). Data points included % referral for physical therapy (PT) or surgery, Hoffa's fat pad edema, tibial tubercle-trochlear groove (TT-TG) distance and lateral trochlear inclination (LTI) angle. Fisher's exact and independent t-tests, ANOVA and regression models were used for statistical analysis.
There is statistically significant difference between Hoffa's fat pad edema patients and control regarding PT referral with G1: 70%, G2: 76%, and control: 53% (p = 0.03). There is statistically significant difference between these groups regarding TT-TG measurements with higher values in edema groups; G1: 11.9 mm±4.1, G2 13 mm ±4.1, and control 8.7 mm±3.6, (p = 0.001). There was a statistically significant association between edema and increased TT-TG distance (p = 0.001) but not LTI angle (p = 0.2).
MRI identification of isolated superolateral Hoffa's fat pad edema is positively associated with TT-TG distance and its presence is associated with higher referral rates to physical therapy for patella maltracking.
外侧髌下脂肪垫（SHFP）水肿的存在与髌股排列和滑车形态相关的几个形态测量值有关。我们的目的是评估 MRI 检查中青少年单纯外侧髌下脂肪垫水肿的处理意义。
回顾性分析了 117 例膝关节 MRI（平均年龄 14.8 岁）检查中单纯外侧髌下脂肪垫水肿的青少年患者。根据水肿涉及的 MRI 轴位切片数将患者分为两组：第 1 组（G1）27 例患者 1 个切片，第 2 组（G2）90 例患者 2 个或更多切片。使用了对照组（45 例 MRI 膝关节正常的患者）。数据点包括物理治疗（PT）或手术转诊率、髌下脂肪垫水肿、胫骨结节-滑车沟（TT-TG）距离和外侧滑车倾斜角（LTI）。采用 Fisher 确切检验和独立 t 检验、方差分析和回归模型进行统计学分析。
G1 组的 70%、G2 组的 76%和对照组的 53%在 PT 转诊方面与髌下脂肪垫水肿患者有统计学显著差异（p=0.03）。G1 组的 11.9±4.1mm、G2 组的 13mm±4.1mm 和对照组的 8.7mm±3.6mm 之间在 TT-TG 测量值方面存在统计学显著差异（p=0.001）。水肿与 TT-TG 距离增加之间存在统计学显著关联（p=0.001），但与 LTI 角度无关联（p=0.2）。
MRI 外侧髌下脂肪垫单纯性水肿的识别与 TT-TG 距离呈正相关，其存在与髌股排列不良的物理治疗转诊率较高相关。
