Hoffa’s Test | Infrapatellar Fat Pad Syndrome Assessment

The infrapatellar fat pad is an intracapsular and extrasynovial adipose tissue occupying the anterior knee joint from the inferior pole of the patella to the proximal tibia. As it is highly vascularized and innervated, impingement of the infrapatellar fat pad is a potential source of nociception causing anterior knee pain that is often overlooked.

This test has not been evaluated in diagnostic studies, which is why we give it a questionable value in clinical practice.

To perform the test, have the patient in supine lying position with the knee flexed to 30-60 degrees. With one hand, the examiner supports the tibia dorsally, while he exerts direct pressure on the medial and lateral side of the inferior pole of the patella. The same process is repeated with the knee in extension. This test is positive for patellar fat pat impingement if the patient reports increased pain upon pressure on either side in the extended position compared to the flexed position.

Hoffa’s Fat Pad Syndrome has to be distinguished from patellofemoral pain. Here are a couple of orthopedic tests to diagnose patellofemoral pain:

• Patellofemoral Pain Diagnosis
• Patellofemoral Pain Cluster
• Decline Step-Down Test
• Clarke’s Sign

Dragoo, J. L., Johnson, C., & McConnell, J. (2012). Evaluation and treatment of disorders of the infrapatellar fat pad. Sports medicine, 42(1), 51-67.