MR Imaging of Extrasynovial Inflammation and Impingement About the Knee

Authors’ Response to a Letter to the Editor

“…MR imaging clearly shows the characteristic pattern of synovial villolipomatous proliferation, allowing a specific and reliable diagnosis. 4 MR imaging findings of frond-like or villolipomatous projections similar in signal intensity to that of the subcutaneous fat on all pulse sequences with associated joint effusion are virtually pathognomonic. 4 Finally, the distal quadriceps tendon layers are often interspersed with fibrofatty connective tissue, resulting in an MR imaging appearance of longitudinal streaks of intermediate signal on most sequencesVnot the quite homogenously black signal expected with the distal portions of many other tendons.…”

“…4 MR imaging findings of frond-like or villolipomatous projections similar in signal intensity to that of the subcutaneous fat on all pulse sequences with associated joint effusion are virtually pathognomonic. 4 Finally, the distal quadriceps tendon layers are often interspersed with fibrofatty connective tissue, resulting in an MR imaging appearance of longitudinal streaks of intermediate signal on most sequencesVnot the quite homogenously black signal expected with the distal portions of many other tendons. 5 We understand that the visual vignettes in your journal are intended to provide your readers samples of Bmany technologies that have been developed in the last few decades to produce and interpret high quality images to help practitioners understand the needs of patients.…”

“…2 In addition to mild to moderate villolipomatous synovial proliferation, the dominant feature of our case was quadriceps fat pad impingement, as we stated in our title, which is compatible with findings in the literature. 3,4 Mild villolipomatous synovial proliferation is a sign of early lipoma arborescens.…”

FAS Disi Alt Ekstremite Sikisma “Impingement” Sendromlari

“…Patella alta (%90), patellar displazi, patellar tendon ve lateral femoral kondil arasındaki kısa mesafe, tibial tüberkül ile troklear oyuk arasında mesafenin artışı ve lateral femoral subluksasyon olası sebepleridir. MRG'de T2A'da yağ yastığının süperolateralinde ödem uyumlu sinyal artışı, patellar tendonun lateralinde fokal tendinopati ve bazen bir kistik oluşum görülebilir (Resim 9 A, B) [30].…”

Re

“…In this setting, sagittal MR images best demonstrate the diagnostic findings of edematous signal alterations and mass effect of the quadriceps fat pad. 3 Lipoma arborescens is a benign villolipomatous proliferation and infiltration of the synovium that most frequently affect the suprapatellar recess of the knee. MR imaging clearly shows the characteristic pattern of synovial villolipomatous proliferation, allowing a specific and reliable diagnosis.…”