Female patient, 29 years old, with long-standing pain complaints since the age of 11, initially attributed to growing pains and no further investigations conducted later. Recently started exercising but facing significant limitations due to the complaint, prompting a request for diagnostics after all these years. Tenderness around and on the patella.
Commencing the ultrasound and ensuring the knee is positioned correctly, a snapping sensation is noted during flexion,
The initial static images of the infrapatellar region shows a severe inflammation of Hoffa's fat pad and fluid present in the deep bursa behind the patellar tendon. Dynamic examination during knee flexion and extension, Hoffa's fat pad herniates laterocranially, consistent with an impingement syndrome. There is a irregular line of the tibial tuberosity at the insertion of the distal patellar tendon, which may indicate a prior Osgood-Schlatter condition.
Hoffa fat pad impingement syndrome, prior Osgood-Schlatter condition.
Esther is a freelance sonography technician with a special interest in abdominal and musculoskeletal ultrasound.
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