Topic
Fat pad sign
About: Fat pad sign is a research topic. Over the lifetime, 58 publications have been published within this topic receiving 920 citations.
Papers published on a yearly basis
Papers
TL;DR: The distribution of joint fluid in the elbow is influenced by flexion and extension of the joint, and radiography is best performed in flexion, while magnetic resonance imaging is most sensitive in identifying effusions, regardless of joint position or location.
Abstract: Rationale and objectives The authors study the distribution of elbow joint fluid with flexion and extension of the joint and evaluate the imaging implications of such distribution. Methods Three cadaveric elbows were studied with radiography, ultrasonography, and magnetic resonance imaging after the incremental injections of 1 to 15 mL of saline solution into the elbow joint. Imaging was obtained with full flexion and extension of the joint. Anatomic sections were obtained for correlation. Results In flexion fluid initially collected posteriorly and, with larger quantities, anteriorly. In extension the anterior fat pad was pressed into its fossa and the posterior fat pad was displaced superiorly by the olecranon process. On lateral radiographs in elbow flexion a positive fat pad sign was seen with 5 to 10 mL of fluid in the joint. Sonography allowed identification of 1 to 3 mL of fluid posteriorly with the elbow flexed. Magnetic resonance imaging allowed identification of 1 mL of fluid, regardless of joint position and location. Conclusions The distribution of joint fluid in the elbow is influenced by flexion and extension of the joint. Radiography is best performed in flexion. Sonography is more sensitive than radiography in diagnosing effusions, but should be performed along the olecranon fossa with the elbow flexed. Magnetic resonance imaging is most sensitive in identifying effusions, regardless of joint position or location.
63 citations
TL;DR: A "paradoxical" positive posterior fat pad sign may occur in some instances of extraarticular disease, and an extended differential diagnosis is presented.
Abstract: Although fat pad signs are classically associated with fracture, there are many nontraumatic disease processes which lead to positive fat pad signs. Any intraarticular fluid or tissue accumulation may result in an abnormal posterior fat pad. A "paradoxical" positive posterior fat pad sign may occur in some instances of extraarticular disease. An extended differential diagnosis is presented.
57 citations
TL;DR: A layer of fat dorsal to the joint which is not normally seen at this site has strikingly often been visible in cases with a suspected fracture of the elbow-joint, and its presence in cases in which no skeletal injury has been detected at an earlier examination may warrant further roentgenologic investigation.
Abstract: In skeletal injuries in children, the elbow-joint is remarkably often involved. All degrees of skeletal changes may be found in a large series of patients who have undergone roentgenologic examination and have a history of injury to the elbow. This applies in particular to supracondylar fractures; they are not uncommonly of the greenstick or infraction type, and the structural changes may be so slight that they are easily overlooked on routine roentgenologic examination. In our experience, greater consideration should be paid to certain, roentgenologically demonstrable changes in the soft tissues surrounding the joint. Their presence in cases in which no skeletal injury has been detected at an earlier examination may warrant further roentgenologic investigation. Thus, in our department, a layer of fat dorsal to the joint which is not normally seen at this site has strikingly often been visible in cases with a suspected fracture of the elbow-joint. As far as I am aware, no similar observations have hitherto been reported in the literature. In order to make a detailed analysis of the normal roentgenologic anatomy of the periarticular soft tissues, I studied a series of 300 roentgenograms of the elbow-joint from our archives. In cases of injury, I studied the unaffected side; the remaining cases consisted of patients sent for an investigation of skeletal development. In none of these cases was any accumulation of fat visible on the
55 citations
TL;DR: The purpose of the present paper is to show that the pads described by Norell are “extrasynovial’ and “intracapsular,” and to demonstrate further their value in radiographic interpretation of obscure elbow joint injuries.
Abstract: Injuries, particularly linear fractures of the radial head, may be difficult to detect in the routine radiographic study of the elbow (1). Kulowski (4) has expressed the need for more accurate diagnoses in elbow fractures. Meschan (8), without elaborating, has stated that the periarticular soft tissues may show evidence of swelling. Norell (9), in an excellent observation, has described fat pad displacement about the humeral fossae in the presence of fractures involving the elbow joint, although he erroneously described the fat as “extracapsular.” A survey of the American radiological and orthopedic literature fails to reveal any report of this “fat pad sign.” The purpose of the present paper is to show that the pads described by Norell are “extrasynovial” and “intracapsular,” and to demonstrate further their value in radiographic interpretation of obscure elbow joint injuries. Displacement of these pads can also be of aid in evaluating the elbow in those local and generalized disease processes which resu...
49 citations
TL;DR: The author's study suggests that a fat pad may be found in the absence of a fracture, being due to a joint effusion only, however, this is difficult to prove because a tiny intracapsular fracture may escape radiological detection.
40 citations
Related Topics (5)
Performance Metrics
| Year | Papers |
|---|---|
| 2021 | 2 |
| 2019 | 4 |
| 2017 | 4 |
| 2016 | 6 |
| 2015 | 2 |
| 2014 | 4 |