Lipoma Arborescens: Review of an Uncommon Cause for Swelling of the Knee

Vleeschhouwer, M. De; Steen, Elke Van Den; Vanderstraeten, Guy; Huysse, Wouter; Neve, Jan De; Bossche, Luc Vanden

doi:10.1155/2016/9538075

Cited by 28 publications

(55 citation statements)

References 28 publications

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“…CT scan although done rarely may demonstrate villous synovial mass with soft tissue density similar to fat with no enhancement on contrast. 11 Lipoma Arborencens can be distinguished from other intraarticular masses with its pathognomic appearance on MRI. It appears as frond like mass with signal intensity similar to subcutaneous fat on all pulse sequences.…”

Section: Discussionmentioning

confidence: 99%

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Lipoma arborescens-a rare cause of monoarticular knee joint swelling in adolescents-case report

Gandhi¹,

Shory²,

Kumar³

et al. 2019

MOJOR

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Lipoma Arborescens is a slowly progressive intraarticular lesion of knee characterised by substitution of sub synovial tissue with fat cells and villous transformation of synovium. 1 It is a rare entity with limited literature. We present a case of lipoma arborescens in 17 year old boy who presented with complaints of mono-articular swelling of left knee for 2 years with history of antecedent trauma. MRI showed frond like masses present in supra and infrapatellar region with high signal intensity on T1W and Intermediate signal intensity on T2W, consistent with fat. He was managed with open synovectomy which showed yellowish white polypoidal and villous masses of adipose tissue. Masses were sent for histopatholgy which showed hypertrophic villous projections of fat lined by synovial cells. Patient became asymptomatic postoperatively and improved functionally.

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Section: Discussionmentioning

confidence: 99%

“…MRI may also demonstrate joint effusion and degenerative changes like chondropathy and osteophytes. 11 Grossly it appears as yellowish white mass with frond like pattern. On histopathology there is papillary proliferation of synovial villi with substitution of subsynovial tissue by mature adipocytes.…”

Section: Discussionmentioning

confidence: 99%

Lipoma arborescens-a rare cause of monoarticular knee joint swelling in adolescents-case report

Gandhi¹,

Shory²,

Kumar³

et al. 2019

MOJOR

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“…Within the knee, the most common site is the suprapatellar pouch. LA is characterised by slowly progressive symptoms of joint pain, with stiffness and an effusion, with cyclic variation of symptoms 16…”

Section: Discussionmentioning

confidence: 99%

“…MRI has been considered to be diagnostic, and characterised by a synovial mass with frond-like architecture, and fat-equivalent signal on all pulse sequences, which does not enhance with contrast administration 16. Furthermore, there is an absence of effects from haemosiderin, which would otherwise be noted in pigmented villonodular synovitis 1 16. Joint fluid aspiration results are often non-specific as are routine investigations used to rule out other causes of joint pain and swelling.…”

Section: Discussionmentioning

confidence: 99%

Lipoma arborescens: a rare cause of clicking in the knee

Nambiar¹,

Onggo

Jacobson

2019

BMJ Case Rep

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Lipoma arborescens (LA) is a rare condition with synovial membrane lipomatous proliferation. It most commonly affects the knee joint, in the suprapatellar pouch. It can present as a painful knee with an effusion. Diagnosis is via MRI demonstrating a synovial mass with frond-like appearance, and histology showing mature adipose cells, with an overlying synovial membrane. Treatment options include non-operative measures with analgesia, or operative intervention to resect the lesion. We describe a unique case of LA present in the anterolateral knee joint, presenting with persistent painful clicking in the knee. The patient underwent an open total resection of the lesion, with resolution of symptoms.

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“…Inflammatory joint features are negligible in osteoarthritis. 1,2 Hence the clinical presence of inflammatory features suggests the possibility of synovitis or arthritis with inflammatory or infective components. The spectrum may include Pigmented Villo-Nodular Synovitis (PVNS), rheumatoid arthritis, tuberculous arthritis, gouty arthritis, CPPD, Lyme's arthritis, SLE, psoriatic arthritis, enteropathic arthritis and reactive arthritis.…”

Section: Discussion and Managementmentioning

confidence: 99%

Atypical Chronic Multiple Joint Swelling- A Case Report

M.N¹

2018

jebmh

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HOW TO CITE THIS ARTICLE: Santhoshkumar MN. Atypical chronic multiple joint swelling-a case report. A 64-year old male patient had recurrent episodes of pain and swelling, predominantly involving bilateral knees with right knee more involved than left over a period of about 4-5 years. Occasionally, he had multiple joint involvement including small joints of hands. There was no characteristic morning stiffness. Clinically, there was effusion in both knees with right knee more involved than left. The yearly recurrence or exacerbations were 3-4 on an average. The aspirations from the joint had an appearance similar to septic arthritis with turbid appearance and on most occasions the quantity was over 60-80 ml in each leg. The more symptomatic side at the time of presentation was often right which alone was surgically interfered with.Apart from non-specific complaints, patient had no significant symptoms to suggest urinary tract infection or GIT infection to consider the possibility of reactive arthritis. However, a turbid knee aspirate along with high total leucocyte count (TLC) with more than 90% PMN and elevated ESR with a negative culture report made a conclusion of reactive arthritis. The chronicity and multiple early recurrence and non-deterioration to the expected level even in absence of antibiotic therapy ruled out a septic arthritic possibility at the same time favouring more chance of reactive arthritis. Moreover, picture of chronicity is not in favour of septic arthritis. Financial or Other, Competing Interest: None. Submission

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Lipoma Arborescens: Review of an Uncommon Cause for Swelling of the Knee

Cited by 28 publications

References 28 publications

Lipoma arborescens-a rare cause of monoarticular knee joint swelling in adolescents-case report

Lipoma arborescens-a rare cause of monoarticular knee joint swelling in adolescents-case report

Lipoma arborescens: a rare cause of clicking in the knee

Atypical Chronic Multiple Joint Swelling- A Case Report

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