Objective: To present a clinical case exploring the occurrence and management of a tear to the infrapatellar fat pad IFP of a high school football player. Background: Acute tears to the IFP are rare. Typically, the IFP becomes impinged (i.e., Hoffa’s disease) through a fall, direct knee trauma, or surgical complications, and requires conservative treatment. Treatment: A 15-year-old high school football player reported to the athletic training clinical complaining of right knee discomfort and the inability to fully flex the knee. The patient stated that during a field goal attempt he missed the ball and hyperextended his right knee. Hoffa’s disease and impingement of the IFP have been well documented, but these injuries have a different mechanism of injury. Uniqueness: More common injuries to the IFP occur because of microtraumas (i.e., Hoffa’s disease) or direct trauma to the knee (i.e., IFP impingement) in older populations. For this patient, the mechanism of injury was non-contact and minimal swelling, and no visual deformity or discoloration were present to suggest an injury. Additionally, the patient was able to complete functional movements with complaining only of “weird tightness” in the knee during extension. Conclusion: Due to the similarity of multiple knee pathologies, unknown mechanisms of injury need to be considered when evaluating the knee structure. Further examination is needed to determine demographic data and the probability of a non-contact injury is to the IFP, especially in pediatric patients.

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Figure 1. Knee MRI: Sagittal view of patient's right knee with IFP tear circled.

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This work is licensed under a Creative Commons Attribution 4.0 License.