Findings
Sagittal PDFS(1) and sagittal T1(2) images show thickening and edema involving the anterior suprapatellar fat pad that shows posterior convexity. Axial PDFS image(3) confirms the findings with significant signal alteration of the quadriceps tendon or degeneration of the patellofemoral compartment. Coronal PDFS(4) shows signal alteration of the medial meniscus that reaches the external surface.
Diagnosis
Anterior suprapatellar fat pad impingement syndrome with grade-II tear of medial meniscus.
Summary
In an unexplained knee pain, it is imperative to have a look at the anterior suprapatellar fat pad. If it shows swelling and edema, this diagnosis can be considered. One should also look at the quadriceps tendon and patellofemoral compartment as they are frequent associations.
Further reads
https://radiopaedia.org/articles/anterior-suprapatellar-fat-pad-impingement-syndrome-1
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