Assessment of anterior subcutaneous hypersignal on proton-density-weighted MR imaging of the knee and relationship with anterior knee pain

Abstract

Purpose: The purpose of this study was to evaluate the prevalence of anterior subcutaneous hypersignal indicating edema on proton-density (PD)-weighted MRI of the knee and to determine whether reporting anterior edema is clinically relevant.

Materials and methods: One hundred and ninety-one knee MRIs from 162 patients were reviewed for anterior subcutaneous edema. There were 92 men and 70 women with a mean age of 41.72years±13.92 (SD) (range, 15-80years) years and a mean body weight of 75.94kg±12.54 (SD) (range, 50-130kg). The MRI findings were compared with patient age, gender, body weight, history of repetitive microtrauma and clinical findings. Patellar and trochlear chondropathy, medial plica, joint effusion, synovitis, infrapatellar fat-pad signal intensity, suprapatellar fat-pad signal intensity with mass effect, quadriceps and patellar tendon abnormalities were also reviewed.

Results: An anterior hypersignal on PD-weighted MRI was detected in 158/191 MR examinations (82.7%) and 104 (84.6%) of these cases had histories of anterior knee pain. No correlation between anterior pain and anterior edema was found (P=0.42). Age (P<0.0001), weight (P<0.0001), and repetitive microtrauma (P=0.001) were identified as significant variables associated with anterior edema.

Conclusion: Anterior edema may be a physiological phenomenon or degenerative change related to patient age, weight, and knee movement or mechanics. It should not be reported as a pathological finding on MRI unless clinical findings support regional infection or inflammation.

Keywords: Bone edema; Bursitis; Knee; Magnetic resonance imaging (MRI).