Have a weird case and would appreciate any help. 30 something year old man with ESRD on dialysis presents with bilateral quad tendon tears after fall. Incidentally seen within the subchondral bone of the bilateral lateral tibial plateaus are these fat-filled lesions with central T1 iso to hypointense signal and central PD FS hyperintense signal. The overlying subchondral bone plates are irregular. My first thought was either intraosseous lipomas or old subchondral cysts replaced with fat. However, that just seems so odd to me to be bilateral in the exact same place. I’m not really worried about malignancy, but anyone have any idea on what the lesions could be? Is there a systemic or syndromic explanation given bilaterality?
Appreciate any help,
Jim
