Hoffa's Fat Pad Pain

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Anatomy and Physiology

The infrapatellar fat pad also known as Hoffa's fat pad is the primary adipose structure within the knee joint. It is found between the joint capsule anteriorly and the synovial membrane posteriorly. It is composed principally of adipocytes but there are also abundant blood vessels and nerves.

The physiological role of the infrapatellar fat pad may be related to shock absorption and protection of adjacent structures.

Pathophysiology

There is inflammation, hypertrophy, and fibrosis of the fat pad with repetitive injury. It can also be a source of pain in knee osteoarthritis.

Clinical Features

Anterior knee pain is the most common symptoms.

Imaging

Imaging findings are unreliable on ultrasound and MRI. Trauma and contusion are the most accurately identified findings. Under ultrasound dynamic assessment can evaluate for impingement.