Hoffa's Fat Pad Impingement (HFPI)

Inclusion Criteria:

* Clinical diagnosis of HFPI (defined as pain to palpation over the medial or lateral aspect of the infrapatellar fat pad, and/or positive hoffa test which is performed by exerting direct pressure over the infrapatellar fat pad as the knee is passively moved from flexion to extension; pain is positive hoffa test)
* Age 12-18 years
* Patients who identify as female
* Organized sports participation is defined as any adult-led game or sport in which three or more people play and/or practice together regularly in a league or association or an adult-led individual athletic activity. Non-organized sport is excluded such as free play.
* Xray and non-contrast MRI of the knee must have been completed for the symptomatic knee
* Must have completed physician-prescribed course of physical therapy for 6-8 weeks

Exclusion Criteria:

* History of patellar dislocation or subluxation, Ehlers-Danlos syndrome, patellar tendinitis/tendinosis, quadriceps tendinitis/tendinosis, medial plica syndrome, osteochondritis dessicans (OCD) of the knee, knee osteoarthritis, prior knee surgery
* Other concurrent knee derangement such as meniscus or ligament tears
* Radiographic evidence of bony abnormalities other than lateral patellar tilt, patella alta/baja, trochlear dysplasia
* MR positive for internal knee joint derangement, synovitis/inflammatory changes/effusion, OCD
* Patients receiving other knee injections during the study time period (i.e., viscosupplementation injection, Toradol injection)