Case Report
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Apr 18, 2015; 6(3): 369-373
Published online Apr 18, 2015. doi: 10.5312/wjo.v6.i3.369
Synovial lipomatosis: A rare cause of knee pain in an adolescent female
Nicholas Miladore, Mary A Childs, Vani J Sabesan
Nicholas Miladore, Mary A Childs, Vani J Sabesan, Department of Orthopaedic Surgery, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI 49008, United States
Vani J Sabesan, Department of Orthopaedic Surgery, Wayne State University School of Medicine, Taylor, MI 48180, United States
Author contributions: Sabesan VJ designed the report; Miladore N, Childs MA and Sabesan VJ collected the patient clinical data and wrote the manuscript.
Ethics approval: The study was reviewed by and received exemption from the Borgess Medical Center Institutional Review Board.
Informed consent: The study participant provided written informed consent for inclusion in this case report.
Conflict-of-interest: All authors declare that they have no conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Vani J Sabesan, MD, Department of Orthopaedic Surgery, Wayne State University School of Medicine, 10000 Telegraph Road, Taylor, MI 48180, United States.
Telephone: +1-313-3757218 Fax: +1-313- 4297981
Received: November 8, 2014
Peer-review started: November 10, 2014
First decision: December 26, 2014
Revised: January 28, 2015
Accepted: February 10, 2015
Article in press: February 12, 2015
Published online: April 18, 2015

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.

Keywords: Synovial lipomatosis, Lipomatosis, Knee arthroscopy, Lipoma arborescens, Arthroscopy, Villous lipomatous proliferation of the synovial membrane, Knee pain

Core tip: This case demonstrates a unique presentation of bilateral knee synovial lipomatosis occurring in an adolescent. Arthroscopic treatment of this disease can yield a successful outcome. This case presentation will increase the awareness of this condition and decrease the tendency toward delayed diagnoses in the adolescent patient.