Prefemoral fat pad impingement syndrome, also known as supratrochlear / posterior suprapatellar fat pad impingement syndrome, is one of the fat pad impingement syndromes of the knee, specifically involving the prefemoral fat pad.
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Clinical presentation
Patients present with anterior knee pain exacerbated by hyperextension.
Pathology
Prefemoral fat pad impingement is caused either by:
prominent suprapatellar osteophyte, with the oedema usually in the superior aspect close to the midline
patellar tendon-lateral femoral condyle friction syndrome, with the oedema, usually occurs in the inferolateral aspect of the fat pad secondary to lateral patellar dynamic subluxation
Radiographic features
MRI
oedema and enlargement of the prefemoral fat pad with high signal intensity on fluid sensitive images
Treatment and prognosis
Initial management is conservative with anti-inflammatory medications. If anterior knee pain persists, arthroscopic evaluation should be considered.
Differential diagnosis
intra-articular lipoma
localised pigmented villonodular synovitis
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