In anterior suprapatellar fat pad impingement syndrome, the cause is usually due to either a developmental cause related to the anatomy of the extensor mechanism or may be related to abnormal mechanics. Infrapatellar (Hoffa’s fat pad) ganglion cyst arising from the anterior cruciate ligament. 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). In fat-pad impingement syndromes, the etiologies are different for each knee fat pad.. It is attached to the knee cartilage at the front of the knee. The typical physical finding for Fat pad (Hoffa's sign) is if you lay down with knee bent and someone places their thumbs on either side of your patellar tendon pushing down it hurts to straighten your knee. It can have any number of different causes, one of which is impingement of the fat pad. Plica is more medial to patella and fat pad (Hoffa's syndrome) is below the patella. Materials and Methods: We prospectively evaluated 1671 knee MRI examinations in 1542 patients for QFP edema with mass effect, which was present in 109 (6.5%) knees. Mr Imbuldeniya is a fellowship-trained consultant orthopaedic surgeon who works in central and west London, and specialises in treating patients with knee problems. This combined with anti-inflamatories and a cortisone injection directly into my fat pad sorted it. Krudwiget and al. 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. Circumscribed 5 mm mass in Hoffa's fat pad with peripheral signal voids due to susceptibility artifacts caused by hemosiderin deposits. The mass showed iso-signal intensity to the muscle peripherally, and a lobulated central osseous lesion showed similar signal intensity to the bone, with a surrounding low-signal-intensity component. Known for his expertise in using robotic and computer technology in surgery and compassionate nature and honesty when treating patients, Mr Imbuldeniya specialises in treating your hip and knee problems, finding the quickest and safest solution with his team. Fat Pad Impingement Anatomy. The infrapatellar fat pad is also known as the Hoffa Pad after being discovered by Albert Hoffa in 1904. From an anatomical point of view, Hoffa's fat pad is a partly adipose wedge-shaped mass formed in the anterior region of the knee that is intracapsular but extrasynovial (and therefore extra-articular). His postgraduate training included Kings College Hospital, Imperial College NHS Trust and Chelsea and Westminster NHS Foundation Trust, where he is now employed. Soft tissue chondroma of the Hoffa (infrapatellar) fat pad is a rare form of chondroma. Numerous traumatic and non-traumatic processes may be encountered, many occurring relative to the anterior compartment, including impingement or friction syndromes. 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. Top Doctors. What Is Fat Pad Syndrome? Ganglion cysts are identifiable on MRI as isointense to fluid with low TI-weighted signal intensity and high T2-weighted signal intensity. Fat pad impingement is among the many sports-related injuries and conditions treated by UW Health's Sports Medicine doctors in Madison, Wisconsin. MRI Anatomy of knee plicae - Duration: 9:45. Purpose: To investigate efficacy and safety of ultrasonography-guided local corticosteroid and anesthetic injection followed by physical therapy for the management of quadriceps fat pad (QFP) edema. See opinions (6), By Mr Arjuna Imbuldeniya Large ganglionic cystic formations arising from the infrapatellar fat pad are quite uncommon and only a few are mentioned in the literature. We find the best specialist for your medical problem reported a ganglion cyst arising from the infra-patellar fat pad of a 10-year-old boy . Knee pain is a very common clinical complaint, especially among active individuals. AJR Am J Roentgenol. Intraosseous ganglia are also very often identified on MR scans. The shaver was introduced first to the medial side and then after adequate debridement to the lateral side looking from the medial side, this area of fat pad was debrided back. Pain, tenderness and swelling around the kneecap and around the sides of the patellar tendon – this is often difficult to localise exactly. The infrapatellar fat pad, known as Hoffa's fat pad, is located posterior to the patellar ligament and adjoining capsule separating them from the synovium. Arthroscopy. Para-articular chondroma of Hoffa fat pad, Para-articular chondroma of the infrapatellar fat pad, Soft tissue chondroma of the infrapatellar fat pad. The infrapatellar fat pad (also known as the Hoffa Pad) is one of three fat pads in the front of your knee. "Superolateral Hoffa's fat pad edema: association with patellofemoral maltracking and impingement." ADVERTISEMENT: Radiopaedia is free thanks to our supporters and advertisers. I've also thought about the bike set-up, and possible over-extention, however I cycled 5000km on the bike during Roth prep training, including several 150km + rides, without any problem. Mass Lesions. Symptoms of Hoffa’s fat pad impingement include: Groups of people who are more prone to Hoffa’s fat pad impingement include those: ACL injuries: everything you need to know. Private patients (without medical insurance). He is an expert in keyhole knee surgery, knee ligament injuries, robotic-assisted knee surgery, cer... Six children, between the ages of 1–8 years, presented with an anterolateral knee mass that was not tender and was only seen and palpable with knee flexion. One of them is impingement of the fat pad. It may occur as a result of metaplasia from mesenchymal cells due to acute or repetitive trauma related to hyperextension of the knee and subsequent inflammation and hemorrhage 4. Any harm to this part can lead to the severe pain which is commonly called as “anterior knee pain”. Ingabire MI, Deprez FC, Bodart A, Puttemans T. Soft tissue chondroma of Hoffa's fat pad. Treat a mass out the ligament length studied 19 … This mass is supported by the shin and thigh bone and considered to be the highly penetrated area with nerves which makes it extremely sensitive. The mass showed iso-signal intensity to the muscle peripherally, and a lobulated central osseous lesion showed similar signal intensity to the bone, with a surrounding low-signal-intensity component. It was described for the first time in 1904 by Albert Hoffa and is defined as acute or chronic inflammation of the infrapatellar fat pad. Soft tissue ganglia are a very common finding with MR Imaging, particularly about the wrist, often presenting due to mass-like symptoms. Here, he gained invaluable experience, learning the latest surgical techniques in hip and knee surgery. On radiograph, soft-tissue mass (asterisks, A) is shown to be completely obliterating fat pad and eroding calcaneus (arrow, A). The fat pad is under continual irritation and could become inflamed.