Hoffa fat pad ganglion cyst
Hoffa fat pad ganglion cysts are intra-articular ganglion cysts, are the most common mass-like lesions within Hoffa’s fat pad and represent one type of many cyst-like lesions around the knee.
Epidemiology
Hoffa fat pad ganglion cysts are rare and less common than cruciate ligament ganglion cysts .
Clinical presentation
Ganglia within Hoffa’s fat pad can be asymptomatic or can cause pain and swelling or present as a palpable mass .
Pathology
Ganglion cysts within Hoffa’s fat pad are usually well-defined, smooth-walled, uni- or multilocular, lobulated cystic masses surrounded by dense connective tissue and filled with viscous, mucinous material like other ganglion cysts. They lack a synovial membrane .
Etiology
Like with other ganglion cysts the pathogenesis is controversial and comprises the following theories :
- a sequel of mucoid degeneration
- cyst formation as a consequence of trauma or tissue irritation
- release of hyaluronic acid by mesenchymal stem cells and consecutive cyst formation
- synovial herniation
- congenital translocation of synovial cells
Location
Ganglion cysts of Hoffa’s fat pad are usually located anterior to the anterior horn of the lateral meniscus .
Radiographic features
MRI
MRI is the best modality for the visualization and evaluation of intra-articular ganglion cysts. The typical appearance is that of a well-defined lobular cystic mass within or adjacent to the Hoffa’s fat pad .
- T1: usually hypointense but will depend on protein content
- T2: hyperintense
- PDFS/T2FS: hyperintense
Treatment and prognosis
Management options depend vastly on clinical symptoms and include conservative measures, image-guided percutaneous aspiration as well as arthroscopic or surgical excision .
Differential diagnosis
Siehe auch:
- Knie Ganglion
- zystische Läsionen des Knies
- synoviale Raumforderungen
- Anomalien des Hoffa'schen Fettkörpers
und weiter:
Assoziationen und Differentialdiagnosen zu Ganglion des Hoffa-Fettkörper:
