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This prospective diagnostic study aimed to assess the utility of machine learning-based quadriceps fat pad (QFP) radiomics in distinguishing patellofemoral osteoarthritis (PFOA) from non-PFOA using Q-Dixon MRI in patients presenting with anterior knee pain. This diagnostic accuracy study retrospectively analyzed data from 215 patients (mean age: 54.2 ± 11.3 years; 113 women). Three predictive models were evaluated: a proton density-weighted image model, a fat fraction model, and a merged model. Feature selection was conducted using analysis of variance, and logistic regression was applied for classification. Data were collected from training, internal, and external test cohorts. Radiomics features were extracted from Q-Dixon MRI sequences to distinguish PFOA from non-PFOA. The diagnostic performance of the three models was compared using the area under the curve (AUC) values analyzed with the Delong test. In the training set (109 patients) and internal test set (73 patients), the merged model exhibited optimal performance, with AUCs of 0.836 [95% confidence interval (CI): 0.762–0.910] and 0.826 (95% CI: 0.722–0.929), respectively. In the external test set (33 patients), the model achieved an AUC of 0.885 (95% CI: 0.768–1.000), with sensitivity and specificity values of 0.833 and 0.933, respectively (p < 0.001). Fat fraction features exhibited a stronger predictive value than shape-related features. Machine learning-based QFP radiomics using Q-Dixon MRI accurately distinguishes PFOA from non-PFOA, providing a non-invasive diagnostic approach for patients with anterior knee pain. [ABSTRACT FROM AUTHOR]

Objective: Peripatellar fat pads are extrasynovial intracapsular fat tissues. Suprapatellar, perifemoral, and infrapatellar (Hoffa fat pad) fat pads are included in the peripatellar fat pad. This study aimed to describe the magnetic resonance imaging (MRI) signs of suprapatellar fat pad impingement syndrome, describe their prevalence and pattern, and look into the relationship between their MRI and clinical signs. Methods: Two radiologists retrospectively analyzed 5,700 patients’ knee MRI data between December 2010 and December 2015. We documented the MRI findings that were associated with suprapatellar fad pad impingement syndrome. The correlations between age, osteoarthritis, chondromalacia, and the patellofemoral joint were evaluated using Pearson’s correlations. Results: In our study group, the prevalence of suprapatellar fat pad impingement was 5.3%. Of the patients 52% were men and 48% were women. Patients who were admitted to the clinic complained of non-specific pain in 80.3% of patients. Twenty-seven patients (8.9%) presented with isolated suprapatellar impingement syndrome; 185 (60.9%) showed an increase in intra-articular fluid; 4 (1.3%) had synovitis findings; 17 (5.6%) had medial collateral ligament tears; 107 (35.2%) had quadriceps femoris tendinitis; 8 (2.6%) had patellar tendinitis; 80 (26.3%) had a medial meniscus tear; 23 (7.6%) had Baker’s cyst; and 30 (9.9%) had soft-tissue edema. Medial meniscus degeneration was observed in 51 (16.8%) patients, Hoffa edema was observed in 31 (10.2%) patients, and anterior cruciate ligament tears in 3 (1%) patients. There were positive correlations between age and osteoarthritis (r=0.4660, p

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Objective: This study aimed to determine the frequency of edematous changes seen in QFP among patients undergoing MRI due to anterior knee pain (AKP) and to elucidate the relation between such changes and other patellofemoral joint pathologies. Materials and Methods: In this retrospective case-control study, individuals with (n=340) and without (n=350) AKP undergoing MRI between January 2018 and January 2020 were evaluated. All images were examined for the presence of QFP edema (QFPE), mass effect and other patellofemoral joint pathologies. The cross-sectional area of QFP was measured and the amount of edema was recorded. Results: QFPE was detected in 79 of the 340 patients with AKP (mean age: 32.29±8.81 years; range: 18-45 years). Mass effects were significantly more common in the AKP group (n=35, 44.3%, p=0.001). The risk of AKP in patients with mass effects was 38.973 times higher compared to patients without mass effects (p=0.001). Patients with diffuse QFPE had a higher risk of AKP than patients with less than 50% edema (p=0.021). Patients with patella alta and increased trochlear sulcus angle had a higher risk of AKP (p=0.029, p=0.006). No other variables were significant risk factors. There was no statistically significant cutoff value for the cross-sectional area. Conclusion: QFPE and mass effects may be associated with AKP independently of other patellofemoral joint pathologies. Therefore, radiologists should be aware of these common findings when analyzing MR images of patients with AKP. [ABSTRACT FROM AUTHOR]

Abstract Background The purpose of this prospective case–control study is to investigate the relationship between quadriceps fat pad syndrome (QFPS) and patellofemoral morphology. Materials and methods Twenty-two patients with QFPS and 22 age- and gender-matched healthy volunteers were included. The diagnosis of QFPS was supported both clinically and radiologically. On magnetic resonance imaging (MRI), patellofemoral morphology was evaluated with 13 radiological measurements including trochlear sulcus angle, trochlear sulcus depth, trochlear facet asymmetry, trochlear condyle asymmetry, lateral trochlear inclination angle, patellar translation, tibial tubercle–trochlear groove (TT–TG) distance, Insall–Salvati ratio, patellotrochlear index, patellar tilt, the ratio between lateral and medial facet lengths, interfacet angle, and quadriceps tendon thickness. The mean of measurements was compared between groups using the Mann–Whitney U test. Results There were 22 patients (12 male, 10 female) with mean age of 30.81 ± 1.41 (range 19–38) years in group I and 22 patients (12 male, 10 female) with mean age of 31.13 ± 1.31 (range 19–39) years in group II. The mean age and the gender distribution were statistically similar between groups (p = 0.845, p = 1, respectively). All measured values except for patellar tilt (p = 0.038) and TT–TG distance (p = 0.004) were similar (p > 0.05 for the other variables). However, all of the measured variables were within the normal range. Conclusions QFPS may not be associated with anatomical variations of the patellofemoral joint. Further studies are required to understand the etiology and risk factors. Level of evidence Level III, prospective case–control study

Background: The purpose of this prospective case-control study is to investigate the relationship between quadriceps fat pad syndrome (QFPS) and patellofemoral morphology.Materials and Methods: Twenty-two patients with QFPS and 22 age- and gender-matched healthy volunteers were included. The diagnosis of QFPS was supported both clinically and radiologically. On magnetic resonance imaging (MRI), patellofemoral morphology was evaluated with 13 radiological measurements including trochlear sulcus angle, trochlear sulcus depth, trochlear facet asymmetry, trochlear condyle asymmetry, lateral trochlear inclination angle, patellar translation, tibial tubercle-trochlear groove (TT-TG) distance, Insall-Salvati ratio, patellotrochlear index, patellar tilt, the ratio between lateral and medial facet lengths, interfacet angle, and quadriceps tendon thickness. The mean of measurements was compared between groups using the Mann-Whitney U test.Results: There were 22 patients (12 male, 10 female) with mean age of 30.81 ± 1.41 (range 19-38) years in group I and 22 patients (12 male, 10 female) with mean age of 31.13 ± 1.31 (range 19-39) years in group II. The mean age and the gender distribution were statistically similar between groups (p = 0.845, p = 1, respectively). All measured values except for patellar tilt (p = 0.038) and TT-TG distance (p = 0.004) were similar (p > 0.05 for the other variables). However, all of the measured variables were within the normal range.Conclusions: QFPS may not be associated with anatomical variations of the patellofemoral joint. Further studies are required to understand the etiology and risk factors.Level Of Evidence: Level III, prospective case-control study. [ABSTRACT FROM AUTHOR]

Objective: To determine if qualitative and quantitative measures of prefemoral fat pad (PFP) and quadriceps fat pad (QFP) are associated with incident radiographic osteoarthritis (iROA) over 4 years in the Osteoarthritis Initiative (OAI) study.Design: Participants in this nested case-control study were selected from the OAI study with knees that had Kellgren Lawrence grades (KLG) of 0 or 1 at baseline. Case knees were defined by iROA (KLG≥ 2) over 4 years. Control knees without iROA were matched 1:1 with case knees. Magnetic resonance images (MRIs) were read at P0 (time of onset of iROA), P-1 (1 year prior to P0) and baseline, and used to assess PFP (i.e., prefemoral hyperintensity alteration, patellofemoral hyperintensity alteration, maximum axial area) and QFP (i.e., hyperintensity alteration, mass effect, maximum axial area). Conditional logistic regression analyses were performed to study the associations between PFP/QFP measures and iROA, after adjustment for covariates.Results: 354 case knees with iROA were matched to 354 control knees. 66.9% of the participants were female, with an average age of 60.1 years. PFP prefemoral hyperintensity alteration measured at three time points (OR [95%CI]: 1.46 [1.18-1.82], 1.50 [1.20-1.88], 1.52 [1.22-1.89] respectively), PFP maximum axial area (OR [95%CI]: 1.07 [1.01-1.14], 1.08 [1.01-1.15], 1.08 [1.02-1.15] respectively) and QFP hyperintensity alteration (OR [95%CI]: 1.59 [1.27-2.00], 1.44 [1.13-1.82], 1.38 [1.09-1.73] respectively) were significantly associated with iROA in multivariable conditional logistic analyses. QFP mass effect measured at BL and P-1 (OR [95%CI]: 1.42 [1.11-1.82], 1.33 [1.01-1.73] respectively) were significantly associated with iROA.Conclusions: Qualitative and quantitative measures of PFP and QFP are associated with increased iROA over 4 years. [ABSTRACT FROM AUTHOR]

Purpose: Quadriceps fat pad is located posterior to the quadriceps tendon. Increased signal intensity of this fat pad is seen on routine knee magnetic resonance imaging (MRI) examinations, but the exact mechanism and related pathologies are not clear. In this study we aimed to evaluate the relationship between MRI signal intensity and morphological features of quadriceps fat pad, as well as various pathologies of the patellofemoral joint. Material and methods: Sixty-one knees with quadriceps fat pad oedema out of 457 knee MRI examinations were included. Quadriceps fat pad signal intensity, dimensions, posterior indentation, and various parameters related to patellofemoral joint such as trochlear facet asymmetry, trochlear depth and sulcus angle, and the Insall-Salvati ratio were evaluated. Results: There was no statistically significant correlation between quadriceps fat pad oedema intensity and its dimensions, but it was significant when compared to posterior indentation. There was no correlation between fat pad oedema and each of the pathologies. However, there was a significant correlation between the presence of fat pad oedema and the presence of at least one of the pathologies related to patellofemoral joint. Conclusions: Quadriceps fat pad oedema detected in MRI examinations should warn the radiologist against the presence of various pathologies related to the patellofemoral joint. [ABSTRACT FROM AUTHOR]

Purpose: Quadriceps fat pad is located posterior to the quadriceps tendon. Increased signal intensity of this fat pad is seen on routine knee magnetic resonance imaging (MRI) examinations, but the exact mechanism and related pathologies are not clear. In this study we aimed to evaluate the relationship between MRI signal intensity and morphological features of quadriceps fat pad, as well as various pathologies of the patellofemoral joint. Material and methods: Sixty-one knees with quadriceps fat pad oedema out of 457 knee MRI examinations were included. Quadriceps fat pad signal intensity, dimensions, posterior indentation, and various parameters related to patellofemoral joint such as trochlear facet asymmetry, trochlear depth and sulcus angle, and the Insall-Salvati ratio were evaluated. Results: There was no statistically significant correlation between quadriceps fat pad oedema intensity and its dimensions, but it was significant when compared to posterior indentation. There was no correlation between fat pad oedema and each of the pathologies. However, there was a significant correlation between the presence of fat pad oedema and the presence of at least one of the pathologies related to patellofemoral joint. Conclusions: Quadriceps fat pad oedema detected in MRI examinations should warn the radiologist against the presence of various pathologies related to the patellofemoral joint. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Physical Medicine & Rehabilitation Sciences is the property of Turkiye Klinikleri and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Partite patella is a known cause of anterior knee pain, especially in adolescents and young males, although most patients are asymptomatic. Symptomatic partite patella is usually revealed on magnetic resonance imaging (MRI) as bone marrow edema within the opposing bone fragments. We present a case of unusual bilateral symptomatic multipartite patella in an adult who presented with quadriceps fat pad edema and mass effect as well as slightly edematous signal changes within the bone fragments on MRI. This case indicates that symptomatic partite patella can also present with edema-like imaging findings in the adjacent soft tissue due to chronic mechanical irritation.

The knee has unique anatomy regarding the relationship between the synovial and capsular layers, with interposed fat pads at certain locations. The extrasynovial impingement and inflammation syndromes about the knee are underdiagnosed and should be included in the differential diagnosis of anterior knee pain. MR imaging is the best imaging modality for evaluation of the anatomy and disorders of these extrasynovial compartments., (Copyright © 2014 Elsevier Inc. All rights reserved.)