The knee has a particular anatomy with regard to the capsular-synovial relationship and contains several interposed fat pads. There is a limited amount of literature on suprapatellar fat pad anatomy of the knee and its pathology is likely underestimated due to underdiagnosis. Fat pad edema can be used as an indirect sign of synovial proliferation in patients with joint effusions. The most important symptom is chronic anterior knee pain proximal to the superior pole of the patella.
Prefemoral fat pad impingement may result from alterations in joint mechanics with repeated microtrauma between the patella and the anterior surface of the distal femur, especially on the lateral side of the fat pad. Mri examination is crucial for a correct diagnosis.
I really like the dynamic Mri exam because in my daily practice gives a further completion of the diagnosis, showing the effective amount of impingement during flexion-extension movements.
Dynamic Mri exam of the same patient