title: Kager's fat pad inflammation associated with HIV infection and AIDS: MRI findings.
abstract: OBJECTIVE
  To describe magnetic resonance imaging (MRI) features of Kager's fat pad inflammation in HIV-positive patients with lipodystrophy due to protease inhibitor treatment and posterior ankle pain.
  
  
  METHODS
  A case-control, cross-sectional study; group 1 included 14 HIV-positive patients using protease inhibitors, presenting lipodystrophy syndrome and having posterior ankle pain; group 2 (CGHIV-) included 112 HIV-negative patients without lipodystrophy syndrome who were being evaluated for posterior ankle pain; group 3 (CGHIV + 1) included 23 HIV-positive patients not using a protease inhibitor, without lipodystrophy syndrome and with posterior ankle pain; group 4 (CGHIV + 2) comprised 18 HIV-positive patients who were being treated with a protease inhibitor and had lipodystrophy syndrome but did not have posterior ankle pain. Images were evaluated for the presence of edema by two radiologists who were blinded to clinical features. Fisher's exact test was used to evaluate differences among the groups. Interobserver variation was tested using Cohen's kappa (κ) statistic.
  
  
  RESULTS
  The presence of edema within Kager's fat pad was strongly associated with symptoms in HIV-positive patients who had lipodystrophy (p ≤ 0.0001). Concordance between observers was excellent (κ > 0.9).
  
  
  CONCLUSIONS
  MRI findings of Kager's fat pad inflammation related to HIV/AIDS is a source of symptoms in HIV patients with posterior ankle pain using protease inhibitors and having lipodystrophy syndrome.
authors.affiliation: Department of Orthopedic Surgery, University of São Paulo, Rua Ovídio Pires de Campos 333 Cerqueira Cesar, São Paulo, SP, 05403-010, Brazil, alexandrelemegodoy@gmail.com.
authors.forename: Alexandre Leme
authors.initials: AL
authors.lastname: Godoy-Santos
authors.forename: Marcelo
authors.initials: M
authors.lastname: Bordalo-Rodrigues
authors.forename: Laercio
authors.initials: L
authors.lastname: Rosemberg
authors.forename: Tulio Diniz
authors.initials: TD
authors.lastname: Fernandes
authors.forename: Ana Lúcia Lei Munhoz
authors.initials: AL
authors.lastname: Lima
authors.forename: Gilberto Luis
authors.initials: GL
authors.lastname: Camanho
authors.forename: Nicola
authors.initials: N
authors.lastname: Maffulli
mesh_terms: D000273:Adipose Tissue / Q000473:pathology*; D000328:Adult; D000843:Ankle Joint / Q000473:pathology; D001938:Brazil / Q000453:epidemiology; D016022:Case-Control Studies; D015897:Comorbidity; D005260:Female; D039682:HIV-Associated Lipodystrophy Syndrome / Q000139:chemically induced* / Q000453:epidemiology / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D015434:Panniculitis / Q000139:chemically induced* / Q000473:pathology*; D015995:Prevalence; D011480:Protease Inhibitors / Q000009:adverse effects*; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity
chemical_list: D011480:Protease Inhibitors