Bilateral Hoffa’s Fat Pad Ganglion Cysts with Subcutaneous Extension

Ganglion cysts within Hoffa’s fat pad are an uncommon cause of anterior knee pain, with bilateral involvement being very rare. We report a unique case of a 42-year-old female presenting with bilateral Hoffa’s fat pad ganglion cysts, complicated by subcutaneous extension and deep infrapatellar bursitis on the left side. Ultrasound-guided aspiration with corticosteroid injection provided symptomatic relief. This case highlights a rare combination of findings which was not previously documented in the literature and this report underscores the importance of bilateral ultrasound scan in diagnosis and individualized approach for management of anterior knee pain.