| Differential: | synovial effusion |
The fabella sign is displacement of the fabella that is seen in cases of synovial effusion and popliteal fossa masses.[1]
The fabella is an accessory ossicle located inside the gastrocnemius lateral head tendon on the posterior side of the knee, in about 25% of people. It can thus serve as a surrogate radio-opaque marker of the posterior border of the knee's synovium. On a lateral radiograph of the knee, an increase in the distance from the fabella to the femur or to the tibia can be suggestive of fluid or of a mass within the synovial fossa. This is of particular use in radiographic detection of knee effusions, as the cause for the effusion may obscure the subcutaneous planes on x-ray that can also be used to determine presence of effusion or effusion size.[2]