VARIANT OF HOFFA DISEASE: A CASE REPORT This report presents the case of an 18-year-old female student with a low BMI, who was otherwise healthy. She presented with chronic anterior right knee pain persisting for 1 year. The pain began spontaneously and gradually increased in severity, especially during long distance walking and standing for more than 15 minutes. The symptoms did not subside with medication and physiotherapy. All biochemical and radiological investigations to rule out other related possible aetiologies were unremarkable. The patient eventually underwent an arthroscopic knee surgery, during which the intraoperative findings revealed the Hoffa fat pad over the anteromedial knee joint. This was debrided and after surgery, she was symptom free and had resumed her normal activities.

A 7-year-old boy presented with both of his thumbs flexed (Figure 1), the inability to perform the ‘thumbs-up’ gesture, and difficulties in opposing thumbs and fingers in activities such as holding a pencil during writing, pincer movements, and picking up small objects. His mother only observed the deformity for one month after the boy complained of difficulty in writing during class. He had no prior history of trauma to the thumbs or pain and swelling in other joints. There were no other birth anomalies noticed by his parents. Upon examination, the boy had flexion deformities of the interphalangeal joint (IPJ) on both of the thumbs. Passive range of motion of the IPJ was not possible and both were fixed at 60° of flexion. Power of both thumbs could not be assessed as there was no motion of the joint. The range of motion of the metacarpophalengeal joints (MCPJ) of both thumbs and all other finger joints was normal. A 0.5cm x 0.5cm subcutaneous nodule was palpable at the volar crease of the MCPJ bilaterally. The nodule was tender on palpation; however, no overlying skin changes were evident.