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Birajdar A, Reddy V, Reddy R. Synovial Lipomatosis in the Knee Joint: A Report of a Rare Condition. Cureus 2024; 16:e71391. [PMID: 39539919 PMCID: PMC11557515 DOI: 10.7759/cureus.71391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2024] [Accepted: 10/13/2024] [Indexed: 11/16/2024] Open
Abstract
Synovial lipomatosis is an uncommon, benign intra-articular lesion that resembles a lipoma and typically affects the synovial lining of the knee joint. It can cause swelling and pain in the joint, as well as restrict movement. Mature fat, proliferating and infiltrating the hypertrophic synovial villi, primarily causes the lesion. Although the hip, glenohumeral, wrist, and ankle joints have also been reported to be affected, the knee joint is a common site of the condition. This benign condition has an unknown cause. This case report describes a 47-year-old male with right knee pain, swelling, and mechanical symptoms. Treatment options include conservative or surgical treatment, depending on the patient's symptom severity. In this case, we opted for surgical management, which included arthroscopic debridement and synovectomy. The occurrence of synovial lipomatosis in the knee is rare, so the treating surgeon must maintain a high level of suspicion.
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Affiliation(s)
- Anteshwar Birajdar
- Orthopedics, Dr. D.Y. Patil Medical College, Hospital and Research Centre, Pune, IND
| | - Vikram Reddy
- Orthopedics, Dr. D.Y. Patil Medical College, Hospital and Research Centre, Pune, IND
| | - Rajeev Reddy
- Orthopedics, Dr. D.Y. Patil Medical College, Hospital and Research Centre, Pune, IND
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Chaiperm C, Ittiravivongs A, Waipanya P, Athikraimongkol B, Narinsorasak T. Simultaneous Concurrent Bilateral Total Knee Replacement in a Patient With Bilateral Lipoma Arborescens With End-Stage Osteoarthritis. Arthroplast Today 2024; 27:101406. [PMID: 38946921 PMCID: PMC11214371 DOI: 10.1016/j.artd.2024.101406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 04/20/2024] [Accepted: 04/28/2024] [Indexed: 07/02/2024] Open
Abstract
A 78-year-old Thai male presented with chronic bilateral knee pain and swelling. X-ray imaging revealed osteoarthritis in both knees, with a suspicious soft tissue shadow. Magnetic resonance imaging suggested lipoma arborescens (LA). The patient underwent LA excision with a complete synovectomy, followed by simultaneous bilateral total knee arthroplasty (SBTKA). Pathological examination confirmed LA. At the 2-year follow-up, the patient reported no complications, adverse outcomes, or recurrence. The intervention improved joint function and pain relief, allowing for early ambulation and full weight-bearing post-surgery. This case highlights the success of complete synovectomy with SBTKA, addressing bilateral knee pathology concurrently. The combined approach reduced operative time and significantly improved joint function and pain relief, emphasizing the benefits of timely surgical intervention and suggest potential advantages of SBTKA for optimal patient outcomes.
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Affiliation(s)
- Chayut Chaiperm
- Department of Orthopaedics, Bhumibol Adulyadej hospital, RTAF, Bangkok, Thailand
| | | | - Puttipol Waipanya
- Department of Orthopaedics, Bhumibol Adulyadej hospital, RTAF, Bangkok, Thailand
| | | | - Thana Narinsorasak
- Department of Orthopaedics, Bhumibol Adulyadej hospital, RTAF, Bangkok, Thailand
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Umetsu A, Eguchi K, Koga T, Araki T, Takatani A, Aramaki T, Terada K, Iwamoto N, Miyahara K, Yonemitsu N, Nakamura H, Kawakami A, Ueki Y. The Evaluation of Lipoma Arborescens with Intermittent Knee Joint Effusion Based on an Analysis of Serum Cytokine Levels and an Immunohistological Examination. Intern Med 2024; 63:1305-1309. [PMID: 37779066 PMCID: PMC11116025 DOI: 10.2169/internalmedicine.2393-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 08/15/2023] [Indexed: 10/03/2023] Open
Abstract
We herein report a 27-year-old woman who presented with recurrent knee pain. Laboratory findings revealed minimal inflammation. Arthrography revealed structures resembling adipose tissues. Magnetic resonance imaging showed a high signal intensity of these structures, leading to the diagnosis of lipoma arborescens (LA). Synovectomy was performed. Pathology revealed adipocyte proliferation and B-cell clusters but no T-cell infiltration. A serum cytokine analysis revealed low levels of interleukin-6 and tumor necrosis factor-α compared with patients with rheumatoid arthritis. The pathogenesis of LA remains unclear, but immunostaining and serum cytokine levels may provide valuable data for future investigations.
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Affiliation(s)
- Ayaka Umetsu
- Department of Rheumatology, Sasebo Chuo Hospital, Japan
| | | | - Tomohiro Koga
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Japan
| | - Takeshi Araki
- Department of Rheumatology, Sasebo Chuo Hospital, Japan
| | | | | | - Kaoru Terada
- Department of Rheumatology, Sasebo Chuo Hospital, Japan
| | - Naoki Iwamoto
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Japan
| | - Kenji Miyahara
- Department of Orthopedic Surgery, Sasebo Chuo Hospital, Japan
| | | | - Hideki Nakamura
- Division of Hematology and Rheumatology, Department of Medicine, Nihon University School of Medicine, Japan
| | - Atsushi Kawakami
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Japan
| | - Yukitaka Ueki
- Department of Rheumatology, Sasebo Chuo Hospital, Japan
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Thavasianantham K, Raagul TS, Ganesh A, Elangovan P, P H, Regunathan PS. Unusual Presentation of Synovial Lipomatosis Mimicking As Septic Arthritis of Knee: A Case Report. Cureus 2024; 16:e58075. [PMID: 38738069 PMCID: PMC11088535 DOI: 10.7759/cureus.58075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/11/2024] [Indexed: 05/14/2024] Open
Abstract
Synovial lipomatosis or lipoma arborescens is a very uncommon pseudo-tumorous lesion of the synovium which more commonly affects the knee joint. The most probable cause of this pathological lesion is degenerative articular disorders of the joint and improper fat accumulation. It is characterized by presence of villous proliferation of the synovium and replacement of the sub-synovial tissue by mature adipocytes which is infiltrated by dense chronic inflammatory cells like lymphocytes, plasma cells and eosinophils. This condition is rarely seen in smaller joints. Its aetiology is still unknown. We report a patient who presented with features of septic arthritis which on intraoperative and histopathological assessment showed features of synovial lipomatosis.
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Affiliation(s)
| | - T S Raagul
- Orthopaedics and Traumatology, Chettinad Hospital and Research Institute, Chennai, IND
| | - A Ganesh
- Orthopaedics and Traumatology, Chettinad Hospital and Research Institute, Chennai, IND
- Orthopaedics, Institute of Medical Sciences and SUM Hospital, Bhubaneswar, IND
| | - Pradeep Elangovan
- Orthopaedics and Traumatology, Chettinad Hospital and Research Institute, Chennai, IND
| | - Haemanath P
- Orthopaedics and Traumatology, Chettinad Hospital and Research Institute, Chennai, IND
| | - Pooja S Regunathan
- Orthopaedics and Traumatology, Chettinad Hospital and Research Institute, Chennai, IND
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Baidoo PK, Nketiah‐Boakye F, Tano EK, Al‐Hassan M, Yorke GOM, Awoonor‐Williams R, Boakye E. Lipoma arborescens in a 16-year-old male: A case report. Clin Case Rep 2021; 9:e05230. [PMID: 34976396 PMCID: PMC8684577 DOI: 10.1002/ccr3.5230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Revised: 12/06/2021] [Accepted: 12/07/2021] [Indexed: 11/10/2022] Open
Abstract
Lipoma arborescens is a benign intra-articular tumor characterized by joint effusions, pain, and reduced range of motion. It is rare in adults and children. We present a case of lipoma arborescens in a 16-year-old male. The work up involved plain radiographs, MRI, incisional biopsy, and laboratory analysis.
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Affiliation(s)
- Paa Kwesi Baidoo
- Directorate of Orthopedics and TraumaKomfo Anokye Teaching HospitalKumasiGhana
| | | | | | | | | | | | - Ernest Boakye
- Department of PathologyKomfo Anokye Teaching HospitalKumasiGhana
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Nishimura H, Suzuki H, Ohnishi Y, Ayeni OR, Sakai A, Uchida S. Arthroscopic Treatment of Synovial Lipomatosis of the Hip, With Concurrent Femoroacetabular Impingement. J Clin Rheumatol 2021; 27:e591-e595. [PMID: 32472778 DOI: 10.1097/rhu.0000000000001259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Haruki Nishimura
- From the Department of Orthopaedic Surgery, University Hospital of Occupational and Environmental Health
| | - Hitoshi Suzuki
- Department of Orthopaedic Surgery, Wakamatsu Hospital for University of Occupational and Environmental Health, Fukuoka, Japan
| | - Yasuo Ohnishi
- Department of Orthopaedic Surgery, Wakamatsu Hospital for University of Occupational and Environmental Health, Fukuoka, Japan
| | - Olufemi R Ayeni
- Division of Orthopaedic Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Akinori Sakai
- From the Department of Orthopaedic Surgery, University Hospital of Occupational and Environmental Health
| | - Soshi Uchida
- Department of Orthopaedic Surgery, Wakamatsu Hospital for University of Occupational and Environmental Health, Fukuoka, Japan
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Orekhova A, Schwarz T. Synovial lipomatosis of the stifle joint in a dog. VETERINARY RECORD CASE REPORTS 2021. [DOI: 10.1002/vrc2.163] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Anna Orekhova
- Moscow private veterinary clinic “Beliy Klyk” Moscow Russia
| | - Tobias Schwarz
- Clinical Veterinary Studies Easter Bush Veterinary Centre The University of Edinburgh Roslin UK
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Mohey N, Hassan TA. Feasibility of MRI in diagnosis and characterization of intra-articular synovial masses and mass-like lesions. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2020; 51:19. [DOI: 10.1186/s43055-020-0138-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 01/13/2020] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Classifications of intra-articular masses are infectious granulomatous diseases, non-infectious synovial proliferative processes (synovial chondromatosis, lipoma arborescens, rheumatoid arthritis, pigmented villonodular synovitis [PVNS]), vascular malformations, deposition disorders, neoplastic, and miscellaneous conditions. The aim of this study is to correlate the results of MRI with arthroscopy in characterization of different varieties of intra-articular synovial masses and mass-like lesions. This observational prospective study was conducted between February 2018 and August 2019. We screened 1000 routine musculoskeletal MRI examination during this period, 32 of which showed intra-articular synovial masses/mass-like lesions. The selected 32 patients (20 males and 12 females) have a mean age of 49.20 ± 2.0 years; all presented with joint swelling, pain, or difficulty of movement according to the joint affected. All patients underwent arthroscopy for histopathological correlation.
Results
The final diagnosis was synovial chondromatosis in 14 patients (43.8%), PVNS in ten patients (31.3%), and lipoma arborescens in five patients (15.6%). Synovial chondrosarcoma, synovial hematoma, and synovial ganglion cyst each in one patient (3.1%). The concordance of MRI to arthroscopy was 96.6% accuracy, 91.7% sensitivity, 99% specificity, 52.3% PPV, and 99.9% NPV.
Conclusion
Good correlation was observed between MRI and arthroscopy in diagnosis of intra-articular synovial masses/mass-like lesions.
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Hamanishi M, Yasunaga Y, Yamasaki T, Mori R, Shoji T, Izumi S, Hachisuka S, Adachi N, Ochi M. Lipoma arborescens of the hip: A case report. J Orthop Sci 2020; 25:188-192. [PMID: 28688812 DOI: 10.1016/j.jos.2017.06.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Revised: 05/19/2017] [Accepted: 06/02/2017] [Indexed: 11/16/2022]
Affiliation(s)
| | - Yuji Yasunaga
- Hiroshima Prefectural Rehabilitation Center, Hiroshima, Japan
| | - Takuma Yamasaki
- Department of Orthopaedic Surgery, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
| | - Ryo Mori
- National Hospital Organization Kure Medical Center, Hiroshima, Japan
| | - Takeshi Shoji
- Department of Orthopaedic Surgery, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
| | - Soutarou Izumi
- Department of Orthopaedic Surgery, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
| | | | - Nobuo Adachi
- Department of Orthopaedic Surgery, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
| | - Mitsuo Ochi
- Department of Orthopaedic Surgery, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
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Theermann R, Ohlmeier M, Hartwig CH, Wolff M, Krenn V, Liewen C, Citak M, Gehrke T. Lipoma arborescens - Uncommon Diagnosis for Joint Swelling: Case Report and Review of the Literature. ZEITSCHRIFT FUR ORTHOPADIE UND UNFALLCHIRURGIE 2019; 158:618-624. [PMID: 31746441 DOI: 10.1055/a-0997-6959] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
INTRODUCTION Soft tissue swelling of the knee joint can be caused by many diseases. Lipomas are one of the most reasonable differential diagnoses we have to consider. Therefore, we now present the uncommon case of a Lipoma arborescens (LA) and differentiate it from a quite similar manifesting spindle cell lipoma as follows. CASE REPORT A 49-years old patient reports about progressive knee pain for four years and observes an increasing joint swelling. This swelling is a soft tissue, shiftable tumour, not painful. The magnetic resonance imaging (MRI) with contrast agent brings the diagnosis of an advanced osteoarthritis of the knee joint and classifies the tumour as LA. Subsequently, we treat the osteoarthritis by implanting a total knee arthroplasty with simultaneous intraoperative tumour resection performed as total synovectomy. The histopathological processing confirms the clinically and radiologically made diagnosis of LA. SUMMARY Lipoma arborescens presents an uncommon subgroup of Lipomas, which is characterized by a slowly progressive increasing soft tissue swelling, especially around bigger human joints. Due to its intraarticular location, the LA might become clinically relevant when it reaches a certain tumour size. Looking at the diagnostics, sonography, MRI and especially the histopathological processing give the crucial results. Final proof can only be made by histopathological examination. Additionally, we have some differential diagnoses to exclude. Under these we predominantly find the spindle cell lipoma, synovial haemagioma, vascular synovial malformations and tenosynovial giant-cell tumour. Furthermore, an atypical lipomatous tumour should be excluded by FISH-analysis via determining the MDM2-Genamplification.
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Affiliation(s)
| | | | | | | | - Veit Krenn
- Gelenkchirurgie, HELIOS ENDO-Klinik Hamburg
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Wang CK, Alfayez S, Marwan Y, Martineau PA, Burman M. Knee Arthroscopy for the Treatment of Lipoma Arborescens. JBJS Rev 2019; 7:e8. [DOI: 10.2106/jbjs.rvw.18.00139] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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FERNANDES TIAGOLAZZARETTI, VIDEIRA LIVIADAU, SASAKI SANDRAUMEDA, NATALINO RENATOJOSÉMENDONÇA, ALMEIDA ADRIANOMARQUESDE, PEDRINELLI ANDRÉ, HERNANDEZ ARNALDOJOSÉ. BILATERAL LOCALIZED PIGMENTED VILLONODULAR SYNOVITIS OF THE KNEE: CASE REPORT AND REVIEW. ACTA ORTOPEDICA BRASILEIRA 2018; 26:183-186. [PMID: 30038543 PMCID: PMC6053968 DOI: 10.1590/1413-785220182603179623] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Objectives Several cases of bilateral diffuse pigmented villonodular synovitis (PVNS) or tenosynovial giant cell tumor have been described in the literature. Nevertheless, some presentations are rare and differential diagnoses are necessary. Methods The purpose of this study was to perform a systematic review of the literature related to PVNS and to report a rare supra-patellar bilateral and focal presentation. We performed a systematic data review in the Pubmed Clinical Queries database using MeSH and keywords related to PVNS and tenosynovial giant cell tumor. Results Two cases of bilateral and local PVNS had been previously described, but neither was localized in the supra-patellar compartment. To our knowledge, this case report is the first to describe supra-patellar bilateral and localized PVNS of the knee. This case involves a 28 -year-old woman with bilateral localized PVNS of the supra-patellar recess of the knee. MRI showed a low-signal intensity nodule in T1- and T2-weighted images. These were associated with hemosiderin pigmentation. Conclusion The most important finding of the case reported is related to rarity and location. Histopathology analysis confirmed a rare case of hemosiderin pigmentation in the capsular nodule with internal non-pigmented villous content. Lipoma arborescens in the supra-patellar form must be ruled out as a differential diagnosis since it occurs in the same site. Level of Evidence IV; Case series.
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13
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Greenspan A, Grainger AJ. Articular abnormalities that may mimic arthritis. J Ultrason 2018; 18:212-223. [PMID: 30451404 PMCID: PMC6442208 DOI: 10.15557/jou.2018.0032] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Accepted: 08/02/2019] [Indexed: 11/30/2022] Open
Abstract
There are numerous abnormalities that present with similar signs and symptoms to arthritis. In this article some of these conditions that can masquerade as arthritis are discussed. Synovial osteochondromatosis is an uncommon benign disorder marked by the metaplastic proliferation of multiple cartilaginous nodules in the synovial membrane of the joints, bursae, or tendon sheaths. Pigmented villonodular synovitis, also known as diffuse-type tenosynovial giant cell tumor, is a locally destructive fibrohistiocytic proliferation, characterized by many villous and nodular synovial protrusions which affects the joints. Synovial hemangioma is a rare benign lesion whose pathogenesis is still unclear. It commonly affects the knee joint, although the other articulations, such as elbow, wrist, and ankle may also be involved. Lipoma arborescens, also known as villous lipomatous proliferation of the synovial membrane, is a rare intra-articular disorder characterized by a non-neoplastic lipomatous proliferation of the synovium. The term "arborescens" refers to the characteristic tree-like morphology of the lesion, which resembles a frond-like mass.
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Affiliation(s)
- Adam Greenspan
- Department of Radiology, University of California School of Medicine, Sacramento, California, USA
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Abstract
Lipomatous lesions are common musculoskeletal lesions that can arise within the soft tissues, bone, neurovascular structures, and synovium. The majority of these lesions are benign, and many of the benign lesions can be diagnosed by radiologic evaluation. However, radiologic differences between benign and malignant lipomatous lesions may be subtle and pathologic correlation is often needed. The use of sonography, computed tomography (CT), and magnetic resonance imaging (MRI) is useful not only in portraying fat within the lesion, but also for evaluating the presence and extent of soft tissue components. Lipomas make up most soft tissue lipomatous lesions, but careful evaluation must be performed to distinguish these lesions from a low-grade liposarcoma. In addition to the imaging appearance, the location of the lesion and the patient demographics can be utilized to help diagnose other soft tissue lipomatous lesions, such as elastofibroma dorsi, angiolipoma, lipoblastoma, and hibernoma. Osseous lipomatous lesions such as a parosteal lipoma and intraosseous lipoma occur less commonly as their soft tissue counterpart, but are also benign. Neurovascular and synovial lipomatous lesions are much rarer lesions but demonstrate more classic radiologic findings, particularly on MRI. A review of the clinical, radiologic, and pathologic characteristics of these lesions is presented.
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Affiliation(s)
- Ashley M Burt
- Department of Radiology, University of California San Diego, 200 West Arbor Drive, Mail Code: 8756, San Diego, CA 92130, USA
| | - Brady K Huang
- Department of Radiology, University of California San Diego, 200 West Arbor Drive, Mail Code: 8756, San Diego, CA 92130, USA
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Gupta P, Potti TA, Wuertzer SD, Lenchik L, Pacholke DA. Spectrum of Fat-containing Soft-Tissue Masses at MR Imaging: The Common, the Uncommon, the Characteristic, and the Sometimes Confusing. Radiographics 2017; 36:753-66. [PMID: 27163592 DOI: 10.1148/rg.2016150133] [Citation(s) in RCA: 72] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Fat-containing tumors are the most common soft-tissue tumors encountered clinically. The vast majority of fat-containing soft-tissue masses are benign. Lipomas are the most common benign fat-containing masses and demonstrate a characteristic appearance at magnetic resonance (MR) imaging. Less common benign soft-tissue masses include lipoblastoma, angiolipoma, spindle cell lipoma/pleomorphic lipoma, myolipoma, chondroid lipoma, lipomatosis of nerve, lipomatosis, hibernoma, and fat necrosis. Well-differentiated liposarcomas (WDLPSs)/atypical lipomatous tumors (ALTs) are locally aggressive soft-tissue masses that do not metastasize. Biologically more aggressive liposarcomas include myxoid, pleomorphic, and dedifferentiated liposarcomas. At MR imaging, lipomas typically resemble subcutaneous fat but may contain a few thin septa. The presence of thick, irregular, enhancing septa and nonfatty soft-tissue mass components suggests liposarcoma rather than lipoma. However, benign lipomatous lesions and WDLPS/ALT often have overlapping MR imaging findings. Distinguishing WDLPS/ALT from a benign lipomatous lesion or from fat necrosis at imaging can be challenging and often requires histologic evaluation. We present the spectrum of fat-containing masses, using the World Health Organization classification of adipocytic tumors, with an emphasis on commonly encountered lesions, characteristic MR imaging findings associated with specific tumors, and overlapping MR imaging findings of certain tumors that may require histologic sampling. We also briefly discuss the role of molecular markers in proper characterization and classification of fat-containing soft-tissue masses. (©)RSNA, 2016.
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Affiliation(s)
- Pushpender Gupta
- From the Departments of Radiology of Kadlec Regional Medical Center, 888 Swift Blvd, Richland, WA 99352 (P.G.); Wake Forest School of Medicine, Winston-Salem, NC (T.A.P., S.D.W., L.L.); and W.G. (Bill) Hefner VA Medical Center, Salisbury, NC (D.A.P.)
| | - Tommy A Potti
- From the Departments of Radiology of Kadlec Regional Medical Center, 888 Swift Blvd, Richland, WA 99352 (P.G.); Wake Forest School of Medicine, Winston-Salem, NC (T.A.P., S.D.W., L.L.); and W.G. (Bill) Hefner VA Medical Center, Salisbury, NC (D.A.P.)
| | - Scott D Wuertzer
- From the Departments of Radiology of Kadlec Regional Medical Center, 888 Swift Blvd, Richland, WA 99352 (P.G.); Wake Forest School of Medicine, Winston-Salem, NC (T.A.P., S.D.W., L.L.); and W.G. (Bill) Hefner VA Medical Center, Salisbury, NC (D.A.P.)
| | - Leon Lenchik
- From the Departments of Radiology of Kadlec Regional Medical Center, 888 Swift Blvd, Richland, WA 99352 (P.G.); Wake Forest School of Medicine, Winston-Salem, NC (T.A.P., S.D.W., L.L.); and W.G. (Bill) Hefner VA Medical Center, Salisbury, NC (D.A.P.)
| | - David A Pacholke
- From the Departments of Radiology of Kadlec Regional Medical Center, 888 Swift Blvd, Richland, WA 99352 (P.G.); Wake Forest School of Medicine, Winston-Salem, NC (T.A.P., S.D.W., L.L.); and W.G. (Bill) Hefner VA Medical Center, Salisbury, NC (D.A.P.)
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Synovial Lipomatosis of the Glenohumeral Joint. Case Rep Orthop 2016; 2016:4170923. [PMID: 27563476 PMCID: PMC4983660 DOI: 10.1155/2016/4170923] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Accepted: 06/29/2016] [Indexed: 11/21/2022] Open
Abstract
Synovial lipomatosis (also known as lipoma arborescens) is a rare and benign lesion affecting synovium-lined cavities. It is characterized by hyperplasia of mature fat tissue in the subsynovial layer. Although the most commonly affected site is the knee joint, rarely additional locations such as tendon sheath and other joints are involved. We present a case of synovial lipomatosis of the glenohumeral joint in a 44-year-old man. The clinical data radiological studies and histopathologic results are described, as well as a review of the current literature.
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Lipoma Arborescens: Review of an Uncommon Cause for Swelling of the Knee. Case Rep Orthop 2016; 2016:9538075. [PMID: 27293937 PMCID: PMC4884798 DOI: 10.1155/2016/9538075] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Accepted: 05/04/2016] [Indexed: 11/22/2022] Open
Abstract
Lipoma arborescens is a rare cause of chronic monoarticular arthritis, with only a few cases reported in the literature. It is most commonly seen in the knee, but cases in other joints such as the wrist, shoulder, and elbow have also been described. It is a benign condition, in which the subsynovial tissue is replaced diffusely by mature fat cells. We describe a case involving the knee and discuss the symptoms, diagnosis, and treatment.
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18
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Shang J, Zou F, Dai M, Zhang B, Nie T. Synovial lipomatosis of the metatarsophalangeal joint: A case report. Oncol Lett 2016; 11:2131-2133. [PMID: 26998135 DOI: 10.3892/ol.2016.4218] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Accepted: 07/07/2015] [Indexed: 11/06/2022] Open
Abstract
Synovial lipomatosis, also termed lipoma arborescens, is an extremely rare disorder of the synovium that causes joint pain, swelling and effusion. To date, only a small number of cases have been reported in the literature. The current study presents the case of a 44-year-old male with repeated swelling of the metatarsophalangeal joints of the left hallux, which had persisted for ~3 years. The main clinical manifestations on presentation included multiple osseous lumps and limited activity of the left hallux without pain. Magnetic resonance imaging of the left hallux revealed a mass surrounding the left metatarsophalangeal joints. Subsequently, the lesion was resected. Pathological examination revealed well-defined lobules of mature adipocytes separated by thin fibrous septa, which indicated a diagnosis of synovial lipomatosis of the metatarsophalangeal joint of the left foot. The aim of this study was to evaluate synovial lipomatosis of the metatarsophalangeal joint, with an analysis of the clinical parameters and pathological features of the disorder.
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Affiliation(s)
- Jiangyinzi Shang
- Department of Orthopedics, The First Affiliated Hospital of Nanchang University, Artificial Joints Engineering and Technology Research Center of Jianxi Province, Nanchang, Jiangxi 330006, P.R. China
| | - Fan Zou
- Department of Orthopedics, The First Affiliated Hospital of Nanchang University, Artificial Joints Engineering and Technology Research Center of Jianxi Province, Nanchang, Jiangxi 330006, P.R. China
| | - Min Dai
- Department of Orthopedics, The First Affiliated Hospital of Nanchang University, Artificial Joints Engineering and Technology Research Center of Jianxi Province, Nanchang, Jiangxi 330006, P.R. China
| | - Bin Zhang
- Department of Orthopedics, The First Affiliated Hospital of Nanchang University, Artificial Joints Engineering and Technology Research Center of Jianxi Province, Nanchang, Jiangxi 330006, P.R. China
| | - Tao Nie
- Department of Orthopedics, The First Affiliated Hospital of Nanchang University, Artificial Joints Engineering and Technology Research Center of Jianxi Province, Nanchang, Jiangxi 330006, P.R. China
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Benegas E, Neto AAF, Teodoro DS, da Silva MVM, de Oliveira AM, Filippi RZ, de Santis Prada F. LIPOMA ARBORESCENS: RARE CASE OF ROTATOR CUFF TEAR ASSOCIATED WITH THE PRESENCE OF LIPOMA ARBORESCENS IN THE SUBACROMIAL-SUBDELTOID AND GLENOHUMERAL BURSA. Rev Bras Ortop 2015; 47:517-20. [PMID: 27047861 PMCID: PMC4799465 DOI: 10.1016/s2255-4971(15)30139-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2010] [Accepted: 07/26/2011] [Indexed: 11/25/2022] Open
Abstract
Lipoma arborescens is a rare intra-articular disease that is usually monoarticular and is characterized by extensive proliferation of the synovial villi and hyperplasia of the subsynovial fat. The synovial tissue is progressively replaced by mature fat cells in the synovial membrane. The present study reports a case of a rare condition of lipoma arborescens that was simultaneously intra-articular (glenohumeral joint) and in the subacromial-subdeltoid bursa, in association with a torn supraspinatus tendon. The clinical, histological and radiographic presentations and treatment are discussed here. The description of this case includes radiographic and magnetic resonance evaluations and pathological examination. Although lipoma arborescens is a rare condition, it should be taken into consideration in cases presenting synovial hyperproliferation and synovial fat replacement.
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Affiliation(s)
- Eduardo Benegas
- Attending Physician in the Shoulder and Elbow Group, Institute of Orthopedics, HC/FMUSP, São Paulo, SP, Brazil
| | - Arnaldo Amado Ferreiro Neto
- Collaborating Professor in the School of Medicine, University of São Paulo, and Head of the Shoulder and Elbow Group, Institute of Orthopedics, HC/FMUSP, São Paulo, SP, Brazil
| | - Daniel Sabatini Teodoro
- Trainee in the Shoulder and Elbow Group, Institute of Orthopedics, HC/FMUSP, São Paulo, SP, Brazil
| | | | | | - Renée Zon Filippi
- Pathologist in the Institute of Orthopedics, HC/FMUSP, São Paulo, SP, Brazil
| | - Flávia de Santis Prada
- Attending Physician in the Shoulder and Elbow Group, Institute of Orthopedics, HC/FMUSP, São Paulo, SP, Brazil
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Abstract
We present a case of lipoma arborescens of the knee in a 17-year-old man, discuss its characteristic imaging findings, and review the relevant differential diagnoses.
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21
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Incidental diagnosis of bilateral synovial lipomatosis in long standing knee osteoarthritis. HUMAN PATHOLOGY: CASE REPORTS 2015. [DOI: 10.1016/j.ehpc.2015.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Miladore N, Childs MA, Sabesan VJ. Synovial lipomatosis: A rare cause of knee pain in an adolescent female. World J Orthop 2015; 6:369-373. [PMID: 25893181 PMCID: PMC4390900 DOI: 10.5312/wjo.v6.i3.369] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2014] [Revised: 01/28/2015] [Accepted: 02/12/2015] [Indexed: 02/06/2023] Open
Abstract
Synovial lipomatosis is a benign proliferative disease of the subsynovial adipose which can lead to a variety of presentations. Cases of synovial lipomatosis in children or adolescents are rare. This case report describes an adolescent patient with a rare bilateral presentation of synovial lipomatosis. She had been treated for years prior to her presentation for juvenile idiopathic arthritis. She presented with chronic bilateral knee pain, swelling, and mechanical symptoms. Bilateral MR imaging demonstrated effusions, hypertrophy of the synovium, and polyp-like projections of tissue with the same signal intensity as fat which is pathognomonic for synovial lipomatosis. Arthroscopic synovectomy and extensive debridement of polyp like fat projections of the right knee was performed. Histopathology was consistent with the synovial lipomatosis diagnosis. Postoperatively, the patient was satisfied with her outcome with improved pain relief and function in her right knee.
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Abstract
Lipoma arborescens is a chronic, slowly progressive intra-articular lesion characterised by villous lipomatous proliferation of the synovium, usually involving the suprapatellar pouch of the knee joint. It is an uncommon cause of intra-articular masses that presents as slowly progressive painless swelling of the joint, which persists for many years and is accompanied by intermittent effusions. We highlight this condition to raise awareness of its clinical spectrum and imaging features, so that early diagnosis and appropriate treatment can be given, and misinterpretation of this condition as other more complex intra-articular masses is avoided. This pictorial essay aims to provide a brief yet comprehensive review of the clinical features, distribution, morphological types and imaging characteristics of lipoma arborescens, including its common differential diagnoses and management.
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Affiliation(s)
- Sarat Kumar Sanamandra
- Department of Diagnostic and Interventional Radiology, Singapore General Hospital, Outram Road, Singapore 169608.
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de Melo EF, Rivera LMS, Quiroz LAD, Bica BERG. [Lipoma arborescens of the knee in a patient with ankylosing spondylitis: case report and literature review]. REVISTA BRASILEIRA DE REUMATOLOGIA 2015; 55:381-3. [PMID: 25805185 DOI: 10.1016/j.rbr.2013.06.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2013] [Accepted: 06/05/2013] [Indexed: 10/24/2022] Open
Abstract
Lipoma arborescens (LA) is defined as a villous lipomatous proliferation of the synovial membrane with diffuse substitution of the synovial tissue by mature fat cells. The injury is very rare, involving the knee joint (suprapatellar region) and is associated with degenerative joint disease. We describe the case of a male patient, suffering from ankylosing spondylitis with monoarthritis of the right knee and swelling in suprapatellar region important. The diagnosis of lipoma arborescens was confirmed from the MRI of the right knee.
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Affiliation(s)
- Elisa Fernandes de Melo
- Serviço de Reumatologia, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil.
| | - Lina Maria Saldarriaga Rivera
- Serviço de Reumatologia, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
| | - Luis Alberto Delgado Quiroz
- Serviço de Reumatologia, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
| | - Blanca Elena Rios Gomes Bica
- Serviço de Reumatologia, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil; Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil.
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Howe B, Wenger D. Lipoma arborescens: Comparison of typical and atypical disease presentations. Clin Radiol 2013; 68:1220-6. [DOI: 10.1016/j.crad.2013.07.002] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2013] [Revised: 06/15/2013] [Accepted: 07/01/2013] [Indexed: 12/28/2022]
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Bent MA, Varacallo M, Fox EJ, Voss S, Frauenhoffer EE. Lipoma Arborescens and Coexisting Psoriatic Arthritis: A Case Report and Review of the Literature. JBJS Case Connect 2013; 3:e121. [PMID: 29252521 DOI: 10.2106/jbjs.cc.m.00079] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
- Melissa A Bent
- Department of Orthopaedics and Rehabilitation, Penn State Milton S. Hershey Medical Center, 30 Hope Drive, Mail Code EC089, Hershey, PA 17033.
| | - Matthew Varacallo
- Department of Orthopaedics and Rehabilitation, Penn State Milton S. Hershey Medical Center, 30 Hope Drive, Mail Code EC089, Hershey, PA 17033.
| | - Edward J Fox
- Department of Orthopaedics and Rehabilitation, Penn State Milton S. Hershey Medical Center, 30 Hope Drive, Mail Code EC089, Hershey, PA 17033.
| | - Sarah Voss
- Department of Pathology, Penn State Milton S. Hershey Medical Center, 500 University Drive, Hershey PA 17033
| | - Elizabeth E Frauenhoffer
- Department of Pathology, Penn State Milton S. Hershey Medical Center, 500 University Drive, Hershey PA 17033
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Progressive bilateral lipoma arborescens of the knee complicated by juvenile spondyloarthropathy: A case report and review of the literature. Semin Arthritis Rheum 2013; 43:259-63. [DOI: 10.1016/j.semarthrit.2012.12.022] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2012] [Revised: 11/30/2012] [Accepted: 12/07/2012] [Indexed: 11/21/2022]
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Stepan JG, Gelberman RH, Rubin DA, Osei DA. Extra-Articular Lipoma Arborescens of the Dorsal Aspect of the Wrist with Invasion of the Extensor Tendons: A Case Report. JBJS Case Connect 2013; 3:e30. [PMID: 29252335 DOI: 10.2106/jbjs.cc.l.00273] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Jeffrey G Stepan
- Washington University in St. Louis, 660 South Euclid Avenue, Campus Box 8233, St. Louis, MO 63110.
| | - Richard H Gelberman
- Washington University in St. Louis, 660 South Euclid Avenue, Campus Box 8233, St. Louis, MO 63110.
| | - David A Rubin
- Washington University in St. Louis, 660 South Euclid Avenue, Campus Box 8131, St. Louis, MO 63110
| | - Daniel A Osei
- Washington University in St. Louis, 660 South Euclid Avenue, Campus Box 8233, St. Louis, MO 63110.
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Rao S, Rajkumar A, Elizabeth MJ, Ganesan V, Kuruvilla S. Pathology of synovial lipomatosis and its clinical significance. J Lab Physicians 2012; 3:84-8. [PMID: 22219560 PMCID: PMC3249723 DOI: 10.4103/0974-2727.86839] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Synovial lipomatosis is a rare disorder of the synovium, commonly affecting the knee joint, resulting in joint pain, swelling, and effusion. The etiology of this condition still remains unclear. AIM This was a study done to evaluate the disease process in synovial lipomatosis, with respect to the clinical parameters and pathological features. MATERIALS AND METHODS Case files of synovial lipomatosis diagnosed on histopathology between 2007 and 2009 were perused, to study the case history, and tissue sections were reviewed for the histomorphological changes. RESULTS Eight cases of synovial lipomatosis were diagnosed on histopathology from year 2007 to 2009, of which one occurred in the wrist joint and the rest were localized to the knee joint. Age ranged from one year to seventy-three years, with a male preponderance. Pain and swelling were major complaints. Three had a significant past history, one occurring post-trauma, one following chikungunya, and another with septic arthritis. Three of the cases had osteoarthritis. Body mass index was elevated in four cases and one case had protein energy malnutrition. On histopathological examination, all the cases showed villous proliferation of the synovium, with focal and diffuse infiltration by mature adipocytes. Four cases showed focal hyperplasia of the lining epithelium and five cases revealed variable fibrosis. CONCLUSION Synovial lipomatosis may mimic tumorous, lesion-like synovial lipoma or hemangioma and its distinct histomorphology helps in distinguishing it from these lesions. It possibly represents a secondary phenomenon following the degenerative process of articular disease of the joints.
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Affiliation(s)
- Shalinee Rao
- Department of Pathology, Sri Ramachandra Medical College and Research Institute, Porur, Chennai, India.
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Jurkiewicz A, Krakowski P, Korolczuk A. Lipoma Arborescens of the Knee Treated with Arthroscopic Synovectomy. JBJS Case Connect 2012; 2:e53. [PMID: 29252551 DOI: 10.2106/jbjs.cc.k.00115] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Andrzej Jurkiewicz
- Orthopaedic Department, 21-010 Łęczna, 52 Krasnystawska, Łęczna Hospital, 20-015, Lublin, Poland. .
| | - Przemysław Krakowski
- Orthopaedic Department, 21-010 Łęczna, 52 Krasnystawska, Łęczna Hospital, 20-015, Lublin, Poland. .
| | - Agnieszka Korolczuk
- Department of Clinical Pathomorphology, Medical University of Lublin, 8 Jaczewskiego, 20-950, Lublin, Poland.
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Silva L, Terroso G, Sampaio L, Monteiro E, Pimenta S, Pinto F, Pinto JA, Ventura FS. Polyarticular lipoma arborescens--a clinical and aesthetical case. Rheumatol Int 2011; 33:1601-4. [PMID: 21526358 DOI: 10.1007/s00296-011-1941-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2010] [Accepted: 04/13/2011] [Indexed: 11/25/2022]
Abstract
Lipoma arborescens is a benign tumor, but it may be a reactive process to other disorders, and its clinical, analytical, radiological and ultrasound presentation may be redundant to any synovial tumor. Despite the characteristic feature on magnetic resonance imaging (MRI), the correct differential diagnosis in atypical presentation, and the need for timely removal of the lesion to prevent joint damage, forces, ultimately, to invasive procedures. The clinical case reported here, fourth described in English language publications on the polyarticular form, also presented other specificities related to one of the swellings, in the knee. Because of its atypical location in the popliteal fossa, recurrent episodes of joint effusion, personal history of knee trauma, pulmonary tuberculosis, and family history of rheumatoid arthritis required particular attention. This process was hampered by the refusal of knee (and ankle) surgery by the patient. He accepted surgical removal of the swellings of the wrists, for aesthetical reasons, with pathologic confirmation of the diagnosis, and clinical success in that location. MRI of the knee showed the typical image of lipoma arborescens, but also other changes that compromise the prognosis.
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Affiliation(s)
- Lígia Silva
- Interna Complementar de Reumatologia, Serviços de Reumatologia do Hospital de São João e da Faculdade de Medicina da Universidade do Porto, Alameda Professor Hernâni Monteiro, 4202-451 Porto, Portugal.
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Momeni M, Tehrani M, Brindle K. Bilateral knee lipoma arborescence diagnosed by ultrasound. Int J Rheum Dis 2011; 14:e10-1. [PMID: 21303470 DOI: 10.1111/j.1756-185x.2010.01589.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Abstract
Lipoma arborescens is a rare clinical condition characterized by mono or biarticular involvement of large joints, such as knees, hips, ankles, elbows, and shoulders. The aim of this case report is to describe an unusual case of lipoma arborescens affecting multiple large joints, mimicking rheumatoid arthritis. The patient, a 29-year-old woman had a history of intermittent arthritis of the wrists, knees, and ankles for at least 12 years. With the diagnosis of rheumatoid arthritis she had been on methotrexate (7.5 mg/wk) for the last 6 months along with different nonsteroidal anti-inflammatory drugs, without benefit. On physical examination a discreet joint swelling of the knees without effusion, gluteal muscle atrophy, and limited hip movements were observed. Laboratory tests presented normal acute phase reactants of inflammation as well as the rheumatoid factor, CK, and negative results for antinuclear, anti-DNA, anti-SSA/Ro, and anti-CCP (ELISA) antibodies. Magnetic resonance imaging of the knees and hips showed articular effusion and synovitis, and a pattern of lipoma arborescens. The histopathologic study confirmed the diagnosis. Knee arthroscopic synovectomy brought some improvement to joint mobility and pain.Although rare, this condition must be remembered in the presence of inflammatory arthropathy, particularly in the absence of response to clinical treatment, and absence of rheumatoid factor and anti-CCP antibodies, since the therapeutic strategy is radically different.
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Jowett C, Mitra P, O'Donnell P, Singh DS. Synovial lipomatosis of hindfoot tendon sheaths: case reports and literature review. Foot Ankle Int 2008; 29:752-5. [PMID: 18785430 DOI: 10.3113/fai.2008.0752] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- Charlie Jowett
- Foot and Ankle Unit, Royal National Orthopaedic Hospital, Stanmore, Middlesex HA7 4LP, United Kingdom.
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Abstract
Collectively, benign synovial disorders are not uncommon, and they may be seen in general orthopaedic practices. Symptoms are nonspecific, often delaying diagnosis. In fact, synovial chondromatosis, pigmented villonodular synovitis, synovial hemangioma, and lipoma arborescens often mimic each other as well as other, more common joint disorders in presentation, making diagnosis extremely difficult. It is important to diagnose these disorders correctly in order to provide appropriate treatment and avoid secondary sequelae, such as bone erosion and cartilage degeneration.
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Abstract
Synovial disorders often affect the knee joint and are a common cause of morbidity. Before MR imaging, radiologists were limited in their ability to provide information about the presence or absence of synovial disease. With the advent of MR imaging, useful information can now be provided to referring clinicians, often at a time when the initiation of therapy may mitigate significantly the long-term sequelae of synovial disorders. MR imaging, owing to its superior soft-tissue contrast, is the imaging modality of choice for demonstrating and quantifying pathologic changes of the synovium. MR imaging provides invaluable information to the clinician regarding the need to either initiate or modify therapy in those patients suffering from diseases of, or affecting, the synovium.
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Frick MA, Wenger DE, Adkins M. MR Imaging of Synovial Disorders of the Knee: An Update. Magn Reson Imaging Clin N Am 2007; 15:87-101. [PMID: 17499183 DOI: 10.1016/j.mric.2007.02.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Synovial disorders often affect the knee joint and are a common cause of morbidity. Before MR imaging, radiologists were limited in their ability to provide information about the presence or absence of synovial disease. With the advent of MR imaging, useful information can now be provided to referring clinicians, often at a time when the initiation of therapy may mitigate significantly the long-term sequelae of synovial disorders. MR imaging, owing to its superior soft-tissue contrast, is the imaging modality of choice for demonstrating and quantifying pathologic changes of the synovium. MR imaging provides invaluable information to the clinician regarding the need to either initiate or modify therapy in those patients suffering from diseases of, or affecting, the synovium.
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Affiliation(s)
- Matthew A Frick
- Division of Musculoskeletal Radiology, Department of Radiology, Mayo Clinic and Foundation, 200 First Street SW, Rochester, MN 55905, USA.
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