Journal CME May 2026: Diagnosis and treatment of the infrapatellar fat pad disorders: A systematic mapping review-PM R - 2025 - Verrier - Diagnosis and treatment of the infrapatellar fat pad disorders A systematic mapping review

PM R - 2025 - Verrier - Diagnosis and treatment of the infrapatellar fat pad disorders A systematic mapping review

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This systematic mapping review examined 137 studies on infrapatellar fat pad (IFP) disorders, a recognized but underdiagnosed cause of anterior knee pain. The authors found that patients most often presented with anterior knee pain worsened by activity, especially squatting, stair climbing, and heavy lifting.<br /><br />Diagnosis relied mainly on clinical examination plus imaging. The most common clinical findings were limited range of motion, pain on palpation, swelling, and positive provocation tests. Magnetic resonance imaging (MRI) was the dominant imaging tool and is currently the practical diagnostic standard. It was especially useful for identifying edema, fibrosis, scarring, impingement, and masses. Radiography, ultrasound, CT, arthroscopy, and histopathology were also used in selected cases, particularly when evaluating calcified/ossified lesions or confirming pathology after surgery.<br /><br />The most frequently reported IFP conditions were masses or pseudomasses, followed by impingement syndromes, postoperative scars, and synovial abnormalities. Terminology varied widely across studies, with many overlapping names for similar conditions, highlighting the need for standardized classification and diagnostic criteria.<br /><br />Treatment was reported in fewer studies than diagnosis. Conservative care included corticosteroid injections, NSAIDs, exercise-based rehabilitation, taping, bracing, and manual therapy. These approaches were most often used for milder or impingement-related cases, but details were often limited and long-term effectiveness was poorly studied. Surgical management was more commonly reported overall, especially mass resection, complete excision, ganglion cyst removal, partial/subtotal fat pad resection, and debridement of fibrosis. Outcomes after surgery were generally favorable.<br /><br />Overall, the review concludes that MRI supported by clinical examination is the main diagnostic approach for IFP disorders, surgery is the most common treatment in the literature, and conservative care is less well studied. The authors call for standardized terminology, validated diagnostic tests, and higher-quality research to guide treatment decisions.

Keywords

infrapatellar fat pad

anterior knee pain

MRI diagnosis

knee imaging

impingement syndrome

fat pad disorders

clinical examination

surgical resection

conservative treatment

standardized terminology