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Should isolated superolateral Hoffa's fat pad edema identified by MRI be reported or ignored in adolescent patients? | LitMetric

AI Article Synopsis

  • The study investigates the implications of superolateral Hoffa's fat pad edema in adolescents with knee issues, focusing on its connection to patellar alignment and trochlear morphology.
  • Researchers reviewed MRI data from 117 adolescents, categorizing them based on the extent of edema and comparing them to a control group of 45 patients with normal MRI findings.
  • Results show that patients with Hoffa's fat pad edema had higher referral rates for physical therapy and greater tibial tubercle-trochlear groove (TT-TG) distances, indicating a link to patellar maltracking.

Article Abstract

Background And Objective: 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.

Materials And Methods: 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.

Results: 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).

Conclusion: 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.

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Source
http://dx.doi.org/10.1016/j.clinimag.2023.06.014DOI Listing

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