I call this Kager’s fat pad fibrosis/atrophy. They can happen due to trauma or post-steroid injection. Few years ago we published in Skeletal Radiology the same aspect in a patient post-steroid injection that was aimed at the Achilles paratenon ( https://pubmed.ncbi.nlm.nih.gov/24615408/) — Attached some extracts from the paper from our case.
Before the injection:
After injection 1 year later:
I don’t know if she’s had peritendimous steroid injection
I have a working relationship with the referrer, so I will ask if she knows about prior intervention
On Mon, Nov 4, 2024 at 3:55 PM hilary umans <hilary.umans> wrote:
This is MRI in a 68F 1 month after twisting injury, having had a prior post traumatic MRI in March of this year.
Findings are very similar in both examinations.
My colleague reported the chronic ATFL tear and stable OCL of the talar dome (not shown), but only reported mild Achilles tendinosis with no mention of the constricted pre Achilles fat pad.
I know there are crural fascial reflections and, laterally, the fibulotalocalcaneal ligament….but how should we report these findings? Should we? Is it clinically relevant? It looks bizarre, but is it correct to ignore it?
