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Objective: The purpose of this study was to evaluate the MRI characteristics of the suprapatellar fat-pad, determine the prevalence and pattern of suprapatellar fat-pad edema, and correlate the findings with the presence of anterior knee pain, patellofemoral malalignment, and patellofemoral joint osteoarthritis., Materials and Methods: We retrospectively reviewed 879 consecutive knee MRI examinations of 843 patients for the presence of a suprapatellar fat-pad mass effect on the suprapatellar joint recess. The relative signal intensity and the maximum anteroposterior, craniocaudal, and oblique diameters of the suprapatellar fat-pad on sagittal fat-suppressed intermediate-weighted turbo spin-echo images were measured. Findings of anterior knee pain, patellofemoral malalignment, and patellofemoral joint osteoarthritis were also recorded. The Fisher exact, Mann-Whitney, and independent samples Student t tests and Spearman rank correlation coefficient were used for statistical analysis., Results: The prevalence of suprapatellar fat-pad mass effect on the suprapatellar joint recess in our study population was 13.8%. The relative signal intensity (p < 0.0001) and maximum anteroposterior (p < 0.0001), craniocaudal (p = 0.0017), and oblique (p < 0.0001) diameters of the pad were significantly greater in patients with a mass effect. Significant correlation was found between the relative signal intensity and the maximum anteroposterior (ρ = 0.0986, p = 0.0053), craniocaudal (ρ = 0.0968, p = 0.0062), and oblique (ρ = 0.123, p = 0.0005) diameters. Mass effect was not significantly associated with anterior knee pain, patellofemoral malalignment, or patellofemoral joint osteoarthritis. Six patients with suprapatellar fat-pad edema had anterior knee pain., Conclusion: Suprapatellar fat-pad edema with a mass effect on the suprapatellar joint recess is a common finding at MRI examinations of the knee that is rarely associated with anterior knee pain.

Peroneal split syndrome refers to longitudinal tearing of the peroneus brevis tendon at the level of the retrofibular groove. It is an increasingly recognized, albeit frequently overlooked, cause of lateral ankle pain. Several surgical options have been documented for managing this entity, however there are no reports emphasizing the role of conservative treatment. A 48-year-old male patient presented to our department with persistent lateral ankle and hindfoot pain over the past 9 months, following an inversion injury to his right ankle. Magnetic Resonance Imaging demonstrated a longitudinal split of the peroneus brevis tendon. Following peroneus brevis targeted physical therapy, the patient remains symptom free 34 months after his injury. Diagnostic diligence is required in order to direct treatment to the diseased peroneus brevis tendon, thus avoiding prolonged morbidity. A trial of conservative treatment in lower-demand middle aged patients should be considered.

Pyogenic haematogenous cervical epidural abscess complicated by tetraplegia is an uncommon entity, but its clinical importance overshadows its rarity. Predisposing risk factors for spinal epidural abscess include diabetes, intravenous drug abuse, liver disease, renal failure, malignancy, HIV, infection elsewhere, rheumatoid conditions, trauma and a number of spinal interventions. Lack of recovery and death are much more frequent when complete paralysis exists since more than 24 to 48 hours. Most authors combine decompressive laminectomy and antibiotics. Anterior decompression and needle aspiration are rarely used, the former more specifically in case of anterior abscess formation. A high index of suspicion along with reliance on gadolinium-enhanced MRI is essential to diagnose the pathology and institute appropriate treatment on an individual basis. The authors report on a diabetic male patient who developed a cervical epidural abscess with tetraplegia after dental extraction. He was treated within six hours by one stage anterior/posterior decompression and fusion, with complete recovery.