IMPROVEMENT OF MRI DIAGNOSTICS IN HOFF'S DISEASE
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Abstract
Actuality. Diagnosis of changes in the volume and structure of Goff's fat body is important due to the relationship of its pathology with pain in the anterior knee joint.
The purpose of the study is to improve the diagnosis of Hoff's disease based on a detailed study of the clinical anatomy of the infrapatellar fat body and generalization of the magnetic resonance picture in normal and pathological conditions.
Material and methods. Protocols of 80 magnetic resonance studies of knee joints with anterior knee pain syndrome were retrospectively selected without a clearly defined traumatic history and positive clinical tests indicating damage to intra- and periarticular elements with revealed structural changes in the fat body. The control group consisted of 25 studies of symptomatic knee joints. In all cases, the pathology was confirmed and corrected during therapeutic and diagnostic arthroscopy.
Results. The magnetic resonance picture of the normal structure of the infrapatellar fat body was determined, as well as pathological changes in the form of a rupture, local edema, diffuse edema, synovial proliferation and fibrosis. Depending on the localization and type of changes, 4 pathological syndromes were identified: "classic" Hoff's disease - 48 (60%) cases, infrapatellar fold syndrome - 10 (12.5%) cases, infrapatellar fold tear syndrome - 5 (6.25%) cases and impingement syndrome of the upper lateral adipose tissue - 17 (21.25%) cases. Conclusion. To identify pathology, careful synchronization of clinical and morphological changes is necessary. Accurate differentiation of syndromes is achieved by knowing the detailed anatomical and magnetic resonance features of the fat body in normal and pathological conditions, which allows diagnosing the cause of the development of pain in the anterior sections of the knee joint, establishing the correct diagnosis and choosing the optimal treatment tactics.
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