Background
Kager’s fat pad is a metabolically active adipose structure within Kager’s triangle anterior to the Achilles tendon, involved in shock absorption, vascular support, and tendon lubrication. Although most research has focused on its role in Achilles tendinopathy and inflammatory conditions, isolated traumatic disruption without concurrent tendon damage has been rarely documented in the literature, to our knowledge. We report a case of an isolated traumatic fracture of the Kager’s fat pad in the absence of concomitant Achilles tendon injury.
Case presentation
An otherwise healthy 31 year-old female presented to the outpatient musculoskeletal office with reported pain at the distal attachment of the Achilles tendon and the lateral ankle after traumatic injury. The patient was doing a clean and jerk, misplaced the barbell which landed on the patients’ foot, forcing the foot into abrupt supination and dorsiflexion. Musculoskeletal ultrasound (MSK US) revealed a fracture of the Kager’s fat pad without injury to the Achilles tendon.
Conclusions
Our case details the importance of considering pathology of the Kager’s fat pad when investigating posterior ankle pain. Further, it shows the utility of MSK US for the identification of this type of injury, especially in the setting of monetary constraints of patients.