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Steroid-induced Kager's fat pad atrophy.
Atul K Taneja1, Durval C B Santos
1Musculoskeletal Radiology Division, Imaging Department, Hospital Israelita Albert Einstein, São Paulo, Brazil, 05652-900, taneja@einstein.br.
Skeletal Radiology
|March 12, 2014
Summary
Corticosteroid injections for Achilles tendinopathy can cause rare Kager's fat pad atrophy and fibrosis. This case report is the first to show these steroid-induced changes using magnetic resonance imaging.
Area of Science:
- Orthopedics
- Radiology
- Pathology
Background:
- Achilles tendinopathy is a common condition often treated with corticosteroid injections.
- Steroid-induced atrophy is a known complication, but typically affects superficial fat layers.
- Deep fat pad involvement, specifically Kager's fat pad, is rarely reported.
Observation:
- A 60-year-old woman presented with symptoms 1 year after a steroid injection for Achilles tendinopathy.
- Magnetic resonance imaging (MRI) revealed atrophy and fibrosis of Kager's fat pad.
- The imaging findings were consistent with steroid-induced changes in the deep adipose tissue.
Findings:
- This case report details the first documented instance of Kager's fat pad atrophy and fibrosis visualized by MRI following steroid injection.
- The findings highlight the potential for corticosteroids to affect deeper adipose tissue layers.
- A review of the literature on steroid-induced fat atrophy is presented.
Implications:
- Radiologists and orthopedic surgeons should consider steroid-induced Kager's fat pad changes in the differential diagnosis.
- This case underscores the importance of careful patient selection and monitoring after corticosteroid injections.
- Further research is warranted to understand the mechanisms and prevalence of steroid-induced deep fat atrophy.
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