Execution
- 1Position the patient supine with the knee flexed and relaxed.
- 2Place one thumb just medial and the other just lateral to the patellar tendon over the infrapatellar fat pad.
- 3Maintain pressure into the fat pad.
- 4Ask the patient to actively extend the knee.
- 5Note whether sharp anterior knee pain is reproduced near terminal extension.
Positive outcome
Sharp anterior knee pain under the patella or along the sides of the patellar tendon during active extension is positive. The test suggests infrapatellar fat pad irritation or impingement. Tenderness should be distinguished from patellar tendon pain.
Studies
| Study | Reliability | Sn | Sp | LR+ | LR− |
|---|---|---|---|---|---|
| Hoffa (1904) | NA | NA | NA | NA | NA |
CommentHoffa's test is a traditional clinical provocation for fat pad irritation, but diagnostic-accuracy literature is limited. It is highly dependent on precise palpation and the patient's extension tolerance. Use it with history of anterior knee pain worse in extension, swelling, and imaging when needed.
Low Clinical Value