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Skeletal Radiol. 2018 Mar;47(3):329-339. doi: 10.1007/s00256-017-2771-x. Epub 2017 Sep 24.

Hyperintense signal alteration in the suprapatellar fat pad on MRI is associated with degeneration of the patellofemoral joint over 48 months: data from the Osteoarthritis Initiative.

Author information

1
Department of Radiology and Biomedical Imaging, University of California, San Francisco, 185 Berry Street, Suite 350, San Francisco, CA, 94107, USA. bschwaiger@gmx.com.
2
Department of Radiology, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany. bschwaiger@gmx.com.
3
Department of Radiology and Biomedical Imaging, University of California, San Francisco, 185 Berry Street, Suite 350, San Francisco, CA, 94107, USA.
4
Department of Radiology, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany.
5
Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA.

Abstract

OBJECTIVE:

To analyze associations of suprapatellar fat pad (SPFP) hyperintense signal alterations and mass effect with progression of patellofemoral osteoarthritis (OA) and clinical symptoms over 48 months.

MATERIALS AND METHODS:

Subjects from the Osteoarthritis Initiative (n = 426; 51.8 ± 3.8 years; 49.8% women) without radiographic tibiofemoral OA underwent 3T-MRI of their right knees and clinical evaluation using the Knee Injury and Osteoarthritis Outcome Score at baseline and at 48 months. Elevated SPFP signal was assessed on intermediate-weighted, fat-saturated turbo spin-echo (TSE) images. Mass effect was defined as a convex posterior contour. Patellofemoral cartilage, bone marrow lesions (BML), and subchondral cysts were assessed using the Whole-Organ Magnetic Resonance Imaging Score (WORMS). Associations of SPFP imaging findings with MRI and clinical progression were assessed using general linear models and logistic regressions.

RESULTS:

Baseline SPFP signal alterations were found in 51% of the subjects (n = 217), of whom 11% (n = 23) additionally had a mass effect. Progression of cartilage lesions was significantly higher in subjects with signal alteration versus without (adjusted mean increases, 95% CI; patella: 0.29, -0.07 to 0.64 vs -0.04, -0.40 to 0.31; p < 0.001; trochlea: 0.47, 0.16 to 0.77 vs 0.31, 0.01 to 0.61; p = 0.007). BML progression was also more likely in subjects with signal alteration (OR 1.75, 95% CI 1.09 to 2.82; p = 0.021). Mass effect was not associated with joint degeneration and SPFP findings were not associated with clinical worsening (p > 0.18 for all).

CONCLUSION:

Patellofemoral joint degeneration over 48 months was significantly increased in subjects with SPFP signal alteration, suggesting an association between SPFP abnormalities and the progression of patellofemoral OA.

KEYWORDS:

Fat pad; Knee; MRI; Osteoarthritis; Patellofemoral; Suprapatellar fat pad

PMID:
28944439
PMCID:
PMC5871621
[Available on 2019-03-01]
DOI:
10.1007/s00256-017-2771-x
[Indexed for MEDLINE]
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