Like the impingement syndrome of the infrapatellar fat pad, also known as Hoffa'sdisease[4, 5, 14-16], abnormalities may also be found in the SPFPs that have typical MRI findings and may be associated with clinical symptoms [10, 11, 17, 18]. Hoffa's infrapatellar fat pad is one of three anterior fat pads of the knee, the other two being the anterior suprapatellar (quadriceps) and posterior suprapatellar (prefemoral) fat pads. Ice regularly - 10-15 minutes, several times per day - to reduce swelling. What causes Infrapatellar fat pad impingement? Aid healing of certain knee injuries (such as infrapatellar fat pad impingement) Correct patella alignment. 10. . 54 Zheng et al 249 reported that preoperative anterior horn cysts showed worse patient-reported outcomes. Diagnosis is made clinically with pain over the medial parapatellar region with possible palpation of a thickened cord. Dysplastic medial trochlea with mal-alignment of the patella. {"url":"/signup-modal-props.json?lang=us\u0026email="}, Dixon A, Hoffa's fat pad impingement syndrome (ultrasound). Since the fat pad is one of the most sensitive areas within the knee, it is thought to be quite painful. This is done in a particular way to relieve the impingement on your fat pad. The infrapatellar (Hoffa's) fat pad explained. bone contusion) can give clues for the mechanism and associated injuries.. Radiographic features. pivot-shift injury. Hoffa impingement. Patients with chondromalacia patellae usually present with anterior knee pain on walking up or down stairs. Conclusion: The findings in our study suggest that edema in superolateral Hoffa's fat pad may be an important indicator of underlying patellofemoral maltracking or impingement in younger, symptomatic patients. ic changes, and fat pad impingement, all of . Publication types Research Support, N.I.H., Extramural MeSH terms Adipose Tissue / pathology* Adolescent Adult Analysis of Variance Repetitive local microtraumas, impingement, and surgery causing local bleeding and inflammation are the most frequent causes of HFP pain and can lead . Associated findings include lateral patellar subluxation and patella alta. patellar tendon lateral femoral condyle friction syndrome, Patellar tendon-lateral femoral condyle friction syndrome, Fat pad impingement syndromes of the knee. All discrep- . The fat pad has an excellent nerve supply, which explains why an injury or damage to it can cause significant pain. Infrapatellar fat pad - A large structure positioned just behind the patellar tendon and the knee cap. Arthroscopy identied two possible sources of bleeding in Hoffa's fat pad and these were coagulated. Epidemiology. Treatment is mainly nonoperative with NSAIDs and physical therapy to focus . The Hoffa's fat pad acts as a protective cushion, which separates the kneecap from the shin and thigh bones. Hoffa's fat pad, also known as the infrapatellar fat pad (IPFP), which are terms that will be used synonymously in this review article, is an intracapsular extra-synovial structure in the anterior knee joint. It is also known as the infrapatellar fat pad syndrome, liposinovitis prepatellaris, syndrome of the infrapatellar fat pad impingement, and hoffitis (2,3). Anterior knee pain with clinically visible thickened band of tissue at anterolateral aspect of patella which 'flicks' at end extension. The trauma may take the form of repetitive hyperextension or rotational strain [ 24 ]. The infrapatellar fat pad, also known as Hoffa fat pad, is the largest of the anterior knee fat pads. The association of patellar tendinosis with patellar maltracking and Hoffa's fat pad impingement: A case-control MRI study Proximal patellar tendinosis was associated with patellar maltracking parameters including patella alta, lateralized tibial tuberosity and superolateral Hoffa's fat pad impingement. The infrapatellar fat pad of Hoffa is commonly injured but rarely discussed in the radiological literature, and contains residual synovial tissue, meaning that primary neoplastic conditions of synovium may originate and be confined to the fat pad. Fat Chance for Hidden Lesions: Pictorial Review of Hoffa's Fat Pad Lesions. Trochlear dysplasia with asymmetrically small medial facet which is < 40% the width of the lateral facet. Radiologists should be cautious in emphasising abnormalities of HFP. ADVERTISEMENT: Radiopaedia is free thanks to our supporters and advertisers. MRI Axial PD Increased T2 signal within Hoffa's fat pad located between the proximal patellar tendon and lateral femoral condyle consistent with patellar tendon lateral femoral condyle friction syndrome also known as Hoffa fat pad impingement syndrome. Check for errors and try again. In acute impingement of fat, the overlying subcutaneous fat becomes hyperechoic . Because disease in this region is not uncommon, it is important to be familiar with the various pathologic entities that may occur here. It is a rare cause of anterior knee pain (4). If the repair of the retinaculum is insufficient, herniation of Hoffa's fat pad can occur and is best visualised and accentuated during flexion of the knee. If pain is present at the front of . Case study, Radiopaedia.org (Accessed on 12 Dec 2022) https://doi.org/10.53347/rID-24314. A tissue biopsy helps in a definitive diagnosis of the condition, which is treated using both conservative methods and surgical procedures (if the signs and symptoms are severe) With . The infrapatellar fat pad - also known as Hoffa's fat pad - is a pad of fatty tissue at the front of the knee, situated behind the patellar tendon and below and behind the kneecap (patella). The Hoffa's fat pad acts as a protective cushion, which separates the kneecap from the shin and thigh bones, protecting the condyle of the femur from being hit by the patella in the case of a direct blow to the kneecap. After a direct blow to the kneecap, the fat pad might end up becoming impinged between the kneecap and the distal thigh bone. Plicae are normal folds of synovial tissue found in the lining of the knee joint and are (in order of decreasing frequency) the infrapatellar plica (ligamentum mucosum), the suprapatellar plica, the medial (mediopatellar) plica, and the . data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAKAAAAB4CAYAAAB1ovlvAAAAAXNSR0IArs4c6QAAAnpJREFUeF7t17Fpw1AARdFv7WJN4EVcawrPJZeeR3u4kiGQkCYJaXxBHLUSPHT/AaHTvu . -Runners knee (patellar tendinits) -Inflamed plica. Sometimes after an acute impact or repetitive traumas, the fat pad can become impinged (pinched) between the distal thigh bone, femoral condyle, and the patella. So what is Infrapatellar fat pad impingement? One week after arthroscopy, hemarthrosis reoccurred for the third time. Case study, Radiopaedia.org (Accessed on 12 Dec 2022) https://doi.org/10.53347/rID-81354. Patients with Hoffa's syndrome report having difficulty sitting in tight seats for long periods of time, such as airplane seats or theatre seats. Case study, Radiopaedia.org (Accessed on 12 Dec 2022) https://doi.org/10.53347/rID-16715, patellar tendon lateral femoral condyle friction syndrome, Patellar tendon-lateral femoral condyle friction syndrome, Fat pad impingement syndromes of the knee. Anatomy Boundaries anterior anteroinferior: patellar tendon anterosuperior: patella posterior The pattern of bone bruise in knee injuries (a.k.a. Independent management, especially for acute fat pad symptoms, requires rest and efforts to reduce inflammation: If overuse, stop the provoking activity. The inflamed fat pad then becomes hypertrophied with predisposition to impingement between the tibia and femur, and thus to further injury. Increased T2 signal within Hoffa's fat pad located between the proximal patellar tendon and lateral femoral condyle consistent with patellar tendon lateral femoral condyle friction syndrome also known as Hoffa fat pad impingement syndrome. Check for errors and try again. Of the 50 examinations, 25 (50%) showed superolateral Hoffa's fat pad edema, and statistically significant differences were seen between those with and without edema with respect to sex (6/22 men vs 19/28 women) and patellar tendon patellar-length ratio (1.3 0.16 and 1.1 0.12 for those with and without edema, respectively). The tibial tuberosity to trochlear groove distance is within normal limits. Reduce the likelihood of injury aggravation. Hoffa's fat pad is a normal part of the human anatomy, and acts as a shock-absorber to cushion the patella and stop it from hitting off the femur (thigh bone) in the case of a direct blow to the front of the knee. Benefits of Fat Pad Taping. ADVERTISEMENT: Radiopaedia is free thanks to our supporters and advertisers. This time a femoral arteri-ography under local anesthesia was performed. It is due to inflammation in the fat pad of the knee or Hoffa's fat pad. A potpourri of the intrinsic and extrinsic pathologies and the tumors and tumor-like conditions affect HFP, and MRI remains the fundamental modality to assess them and provide a specific diagnosis. 2 the deep peripheral margins of hoffa's fat pad are attached to the anterior horns of the The fat pad is intraarticular meaning it actually sits within the joint but outside the synovium (joint capsule). Fat Pad Impingement. Hoffa's fat pad impingement syndrome (ultrasound) Case contributed by Dr Andrew Dixon Diagnosis certain Share Add to Citation, DOI & case data Presentation Anterior knee pain with clinically visible thickened band of tissue at anterolateral aspect of patella which 'flicks' at end extension. ADVERTISEMENT: Supporters see fewer/no ads. Hoffa's fat pad abnormalities, knee pain and magnetic resonance imaging in daily practice. Saxena S, Patel DD, Shah A, Doctor M The Indian journal of radiology & imaging , November , 2021 Underlying evidence of lateral patellar maltracking with patellar alta and trochlear dysplasia (asymmetrically small medial trochlear facets). We evaluated all three fat pads, specifically focusing on edema in the superolateral portion of Hoffa's fat pad. Gielen (eds.) The fat below the caudal margin of the patella shows an abnormal increased signal, associated with moderate patella alta. There is a recognized female predilection. Impingement of the infrapatellar fat pad (Hoffa's disease) is one of the causes of anterior knee pain. The tibial tuberosity to trochlear groove distance is within normal limits. Hoffa's (infrapatellar) fat pad (HFP) is one of the knee fat pads interposed between the joint capsule and the synovium. Hoffa fat pad impingement syndrome occurs secondary to patellar maltrackingor imbalance of the forces between medial and lateral vastus muscles causing impingement of the superolateral aspect of Hoffa fat padbetween the inferior patella and the lateral femoral condyle. Medicine. Indications and Specications for Ultrasound Guided Procedures Ultrasound has become an indispensable tool for image guidance of interventional procedures within the MSK system. Fat Pad Impingement or Hoffa's Syndrome Hoffa Syndrome Arthroscopic Treatment by Dr HC Chang .wmv Watch on The pain went away immediately after the surgery. Hoffa's fat pad impingement syndrome (ultrasound), Patellar tendon-lateral femoral condyle friction syndrome, Fat pad impingement syndromes of the knee. Underlying evidence of lateral patellar maltracking with patellar alta and trochlear dysplasia (asymmetrically small medial trochlear facets). Hoffa's disease (also known as a syndrome of infrapatellar fat pad impingement) is a condition described by Albert Hoffa in 1904, in which acute trauma or repetitive microtrauma to the fat pad causes haemorrhage and inflammation. It is located immediately posterior to the patellar tendon and is traversed during knee arthroscopy. Received 2012 Nov 7; Revised 2013 Feb 14; Accepted 2013 Feb 19. Repeat 3 times. The IFP is densely innervated2-4), so impingement can cause acute or chronic sharp pain in the infrapatellar region5-7). . Structurally it is composed of adipose tissue similar to subcutaneous fat 1. Patient Data Age: 35 years Gender: Male ultrasound in 65% of knees, the deep midline margin of hoffa's fat pad gives rise to a fan-shaped infrapatellar plicae or ligamentum mucosum that narrows as it propagates into the intercondylar notch paralleling the course to the anterior cruciate ligament (acl). However, data on the relevance of MRI findings . Increased T2 signal within Hoffa's fat pad located between the proximal patellar tendon and lateral femoral condyle consistent with patellar tendon lateral femoral condyle friction syndrome also known as Hoffa fat pad impingement syndrome. It's sometimes called Infrapatellar fat pad syndrome. Case study, Radiopaedia.org (Accessed on 12 Dec 2022) https://doi.org/10.53347/rID-16715. Repeat times 10 times rest 1 minute. Knee pain is often nestles anteriorly on either . For subtle cases of fat pad edema, a region of interest measurement of signal intensity in the superolateral portion had to be 20% higher than the surrounding normal fat pad signal to be recorded as positive. It was first found by Albert Hoffa in 1904, hence its name and it doesn't need much explanation as to what it is. Patient Data Age: 40 Gender: Male MRI Loading images. Push back up to the starting position. The abnormal IPP caused impingement of the posterior aspect of Hoffa's fat pad at the intercondylar notch and femoral trochlea, limiting full extension of the knee. European Journal of Radiology 2008; Extra 68:29-32. Patella alta is usually defined as a height ratio of > 1.3. Plica syndrome is defined as a painful impairment of knee function resulting from the thickened and inflamed synovial folds (usually medial). Plicae. Hoffa's syndrome, also known as infrapatellar fat pad syndrome, is a problem which affects one of three pads of fatty soft tissue that lies under the kneecap (patella) and leads to pain at the front of the knee. Hoffa's fat pad (HFP) is richly innervated and, therefore, a source of anterior knee pain. The fat pad should be clearly seen as a heterogeneous hypoechoic mass bulging through the retinaculum. The normal ratio is 1.1. 22). 4 Radiology Institute, University of Pavia, Via Oberdan 21, 27100, . Hoffa's fat pad is a normal part of human anatomy, and acts as a shock . It's location is as follows: deep to the patella tendon which it attaches to superior attachment is to the lower patella (knee cap) inferior attachment on the anterior tibia. 65 Anterior lateral cysts extended medially either into the root or into the Hoffa fat pad, but in some cases, the type of extension did not correlate with the presence of an underlying meniscal tear. Objectives and Methods. ADVERTISEMENT: Radiopaedia is free thanks to our supporters and advertisers. Check for errors and try again. The fat below the caudal margin of the patella shows an abnormal increased signal (arrows), associated with moderate patella alta. You can use Radiopaedia cases in a variety of ways to help you learn and teach. The infrapatellar fat pad, also known as the Hoffa's fat pad, sits behind and just below the kneecap between the shin (tibia) and thigh (femur) bones. You can use Radiopaedia cases in a variety of ways to help you learn and teach. Hoffa's Syndrome (or Hoffa's fat pad impingement) represents hypertrophy and inflammation of the infra-patellar fat pad secondary to impingement between the femoral condyles and tibial plateau during knee extension. Posterior Hoffa`s fat pad impingement secondary to a thickened infrapatellar plica: a case report and review of the literature Case Report Arnold Radu 1 *, Federico Discepola 1, Monika Volesky 2, Peter L Munk 3, Huy Le 1 Radiology Case. A: The thickness of Hoffa's synovitis is measured at three points at the proximal, middle, and distal synovium along the posterior aspect of the Hoffa's fat pad (yellow arrow); B: Sagittal slices are selected at the medial, lateral, and central patellofemoral groove. Radiology (ESSR), and American Institute of Ultrasound in Medicine (AIUM) serve as a framework for proper utilization of ultrasound in clinical PM&R practice [5]. It has been termed Hoffa's Syndrome as but can also be known as fat pad impingement. Ultrasound appearances ofHoffa's fat pad impingement syndromefrom patellar maltracking. Patients with abnormalities of the HFP on MRI are often but not always symptomatic. The infrapatellar fat pad of Hoffa is commonly injured but rarely discussed in the radiological literature. valgus stress to flexed and externally rotated knee; contusion pattern: posterolateral tibial plateau and mid part of lateral femoral condyle lateral Hoffa's fat pad edema (Student's t test, p = 0.39). Hoffa fat pad ganglion cysts are intra-articular ganglion cysts, are the most common mass-like lesions within Hoffa fat pad and represent one type of many cyst-like lesions around the knee. Repetitive local microtraumas, impingement, and surgery causing local bleeding and inflammation are the most frequent . Check for errors and try again. Hoffa's syndrome, otherwise known as infrapatellar fat pad impingement, is a problem which causes pain at the front of the knee (anterior knee pain). Infrapatellar fat pad (IFP) impingement, first described by Hoffa1)in 1904, is an impingement syndrome caused by edema and swelling of the IFP between the patella and the femoral condyle. Use of NSAID's, if approved by your doctor, to reduce inflammation. Some nonsense diagnoses you may be given by doctors and physios who . A false aneurysm of a branch of the inferior lateral geniculate Sub-synovial swelling and edema between the lateral femoral condyle and the lateral patellar ligament at the apex patellae. Subsequently, the IPP was shaved down completely, resulting in release of the posteriorly tethered portion of Hoffa's fat pad. Hoffa's fat pad (HFP) is the most commonly afflicted among all the knee fat pads. Patellar tendon-lateral femoral condyle friction syndrome. Hoffa's (infrapatellar) fat pad (HFP) is one of the knee fat pads interposed between the joint capsule and the synovium. The normal ratio is 1.1. Draghi F, Ferrozzi G, Urciuoli L, et al. The fat pad is spongy fat tissue located just below the kneecap, which means any bad positioning of the kneecap can compress and irritate it, causing pain. {"url":"/signup-modal-props.json?lang=us\u0026email="}, Dixon A, Hoffa fat pad impingement syndrome. The fat pad has been shown to be very pain sensitive. Hoffa disease is a syndrome of infrapatellar fat pad impingement, due to single or repetitive traumatic episodes, with hyperextension and rotational forces resulting in hemorrhage. Department of Radiology, 412 General Military Hospital-212 Mobile Army Surgical Hospital, Terma Lefkou Pyrgou, Xanthi, 67100 Greece . Author(s): Filip M. Vanhoenacker,Mario Maas,Jan L.M.A. Epidemiology Hoffa fat pad ganglion cysts are rare and less common than cruciate ligament ganglion cysts 1,2. ADVERTISEMENT: Supporters see fewer/no ads. They then report having to straighten their knee every few minutes to stop the pain. Online Course: Adolescent Patellofemoral Pain Introduction Acute or chronic inflammation of the Infrapatellar Fat Pad (IFP) is a common source of Anterior Knee Pain; also called Hoffa's disease, fat pad syndrome or hoffitis. You can use Radiopaedia cases in a variety of ways to help you learn and teach. Chondromalacia patella with generally increased cartilage signal and focal fissuring centrally and trace associated subchondral edema. ADVERTISEMENT: Supporters see fewer/no ads. + This is a course page funded by Plus online learning 24-25 Ganglion within the infrapatellar fat pad are most often located adjacent to the anterior horn of the lateral meniscus or transverse intermeniscal ligament. It is a very common cause of anterior knee pain, but one that is very often misdiagnosed, or not diagnosed at all. Abnormalities within it most commonly . Radiological findings include focal area of high T2 signal (edema) at the inferolateral aspect of the patellofemoral joint, within the superolateral portion of the infrapatellar fat pad. There are various fat pads, but the one at the knee that causes a lot of problems is the infrapatellar fat pad, also known as Hoffa's fat pad after the man who first described it. With biomechanics, the fat pad is more susceptible to being pinched if there is excessive movement of the knee into extension (straightening of the knee), such as with hypermobility. Unable to process the form. Located posterior to patellar tendon and anterior to the capsule, the HFP is richly innervated and, therefore, one of the sources of anterior knee pain. There are four main causes of Hoffa's fat pad impingement: biomechanics, repeated hyperextension in sport, acute hyperextension with an injury, and direct trauma. The patella height ratio of 1.4 is consistent with patella alta. Annotated image Annotated image The patella height ratio of 1.4 is consistent with patella alta. Posted on 06th Feb 2018 / Published in: Knee. . Simply, it is either an acute or chronic inflammation or impingement of the infrapatellar fat pad causing pain, swelling and loss of function. See Also: Homans Sign A variety of benign cystic or "cyst-like" lesions may be encountered during a routine magnetic resonance imaging . The patella height ratio of 1.4 is consistent with patella alta. Check for errors and try again. It is rich with nerve endings that can fire off messages of . HFP disorders are related to traumas, involvement from adjacent disorders and masses. Patella alta with Hoffa's fat pad impingement | Radiology Case | Radiopaedia.org Patella alta with Hoffa's fat pad impingement Case contributed by Dr Roberto Schubert Diagnosis certain Share Add to Citation, DOI & case data Presentation Anterior knee pain persisting for years. Publisher . Additionally, there may be knee pain when kneeling, squatting, or after sitting for long periods of time. Hoffa fat pad impingement syndrome occurs secondary to patellar maltracking or imbalance of the forces between medial and lateral vastus muscles causing impingement of the superolateral aspect of Hoffa fat pad between the inferior patella and the lateral femoral condyle. ADVERTISEMENT: Radiopaedia is free thanks to our supporters and advertisers. Fat pad syndrome was firstly reported by Albert Hoffa in 1904 [1] . Unsere Top Vergleichssieger - Finden Sie bei uns die Grey goos vodka Ihrer Trume Unsere Bestenliste Dec/2022 - Detaillierter Produkttest Ausgezeichnete Modelle Aktuelle Angebote : Smtliche Preis-Leistungs-Sieger Direkt weiterlesen! As the fat pad is one of the most sensitive structures in the knee, this condition is known to be extremely painful The resulting pain, swelling and fat hypertophy limits range of motion. Read this in-depth article to find out more. {"url":"/signup-modal-props.json?lang=gb\u0026email="}, Dixon A, Hoffa fat pad impingement syndrome. Abstract The infrapatellar fat pad of Hoffa is an intracapsular structure that is routinely visualized on magnetic resonance images of the knee. Case study, Radiopaedia.org (Accessed on 12 Dec 2022) https://doi.org/10.53347/rID-25157. Ganglion of Hoffa's Fat Pad The infrapatellar fat pad is one of the most common locations for a ganglion cyst to occur at the knee, accounting for approximately 13% of all intra-articular ganglia (Fig. Coronal STIR You can use Radiopaedia cases in a variety of ways to help you learn and teach. Anterior knee pain is common in various pathologies of HFP, as it is richly innervated. ADVERTISEMENT: Supporters see fewer/no ads. You can use Radiopaedia cases in a variety of ways to help you learn and teach. Read this in-depth article to find out more. Fat pad Impingement , is a problem which affects one of three pads of fatty soft tissue that lies under the kneecap (patella) and leads to pain at the front of the knee. Chondromalacia patella with generally increased cartilage signal and focal fissuring centrally and trace associated subchondral oedema. However, there were more women High-riding dysplastic patella (patella to patellar tendon length = 1:1.6) with obvious signs of chondromalacia. The transverse ligament and ACL can also be the origins. Squat down keeping your knee in line with the toes and your pelvis level. MRI findings of HIV-related Hoffa's fat-pad inflammation include diffuse homogeneous increased signal intensity in Hoffa's fat pad on fluid-sensitive . separates it from the prefemoral fat pad [10-13]. {"url":"/signup-modal-props.json?lang=us\u0026email="}, Ibrahim D, Hoffa fat pad impingement syndrome. 2015 Mar; 9(3):20-26 :: DOI: 10.3941/jrcr.v9i3.2037 {"url":"/signup-modal-props.json?lang=us\u0026email="}, Schubert R, Patella alta with Hoffa's fat pad impingement. In prefemoral fat pad impingement syndrome, the cause is either secondary to a prominent suprapatellar osteophyte, with the edema usually in the superior aspect of the prefemoral fat pad close to the midline or secondary to patellar tendon-lateral femoral condyle friction syndrome, with the edema, usually in the inferolateral aspect of the fat pad. ADVERTISEMENT: Supporters see fewer/no ads. When used correctly, infrapatellar fat pad taping techniques can: Decrease pain during sport or activity. The infrapatellar fat pad is an intracapsular structure and plays a role in stabilizing the patella in extremes of flexion and extension. Series: Medical Radiology Title: Imaging of Orthopedic Sports Injuries Edition: 2nd ed. Some of the more common things are: -Damage to the cartilage on the knee cap or the kneecap groove (we call this chondromalacia patella) -Kneecap arthritis (patellofemoral arthritis) -Hoffa's Syndrome or fatpad impingment. Insights Imaging 2016; 7(3):373-83. doi: 10.1007/s13244-016-0483-8; Clinical presentation Patella alta is usually defined as a height ratio of > 1.3. There are several issues that may result in Hoffa's fat pad impingement: Imbalance in the knee muscles Previous kneecap dislocation Previous trauma of the kneecap Hypermobility Unable to process the form. Patella alta with Hoffa's fat pad impingement, GD: Paediatrics - MSK - Variants, Fractures & Periosteal reaction. Increased T2 signal within Hoffa's fat pad located between the proximal patellar tendon and lateral femoral condyle consistent with patellar tendon lateral femoral condyle friction syndrome also known as Hoffa fat pad impingement syndrome. [1] Technique The knee is flexed and each fat pad is tested by applying pressure to the medial or lateral side of the patellar tendon. You may need to keep your knee taped until your pain has gone. Abstract. Hoffa's disease was first defined as an acute or chronic inflammation of the infrapatellar fat pad by Albert Hoffa in 1904 (1). The third type of impingement that may affect Hoffa's fat pad is related to the infrapatellar plica and is termed posterior Hoffa's fat pad impingement. Clinical presentation. reviewed by one third-year radiology resident and one board-certified radiologist with 8 years of ex-perience in musculoskeletal imaging. . Tends to occur in young adults. Five classic bone contusion patterns have been described 1-4:. A high-riding patella, a short distance between the patellar ligament and the lateral trochlear facet, and an increased distance from the tibial tubercle to the trochlear groove are associated with superolateral Hoffa fat pad edema at MR imaging. For more information on Hoffa's syndrome, please contact us at 65-683 666 36 or email us at hcchang@ortho.com.sg You may wish to visit our website at http://www.ortho,com.sg Loading. Trochlear dysplasia with asymmetrically small medial facet which is < 40% the width of the lateral facet. It is attached to the knee cartilage ( menisci) at the front of the knee. Hoffa's test is used to clinically diagnose impingement of the infrapatellar fat pad. As your technique improves and pain reduces, you can progress the exercises to a deeper squat. Unable to process the form. Unable to process the form. Hoffa disease was described in 1904 as a syndrome of infrapatellar fat-pad impingement related to an inflamed fat pad of . Unable to process the form. The location is thought to expose the fat pad, making it more suspectable to injury, especially during the end of range knee extension (straightening) (1). This syndrome was first described by Hoffa in 1904. Symptomatic echogenic edematous fat within the proximal lateral portion of Hoffa's fat pad consistent with Hoffa's fat pad impingement syndrome (patella tendon lateral femoral condyle friction syndrome) from patellar maltracking. Hoffa Disease is also known as Fat Pad Impingement Syndrome, because of the impingement of the fat between the patella and the lower portion of the thigh bone. Allow an earlier return to sport or activity following injury. 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