Bilateral lipoma arborescens with osteoarthritis knee: Case report and literature review

Abstract

Lipoma arborescens is villous proliferation of synovium and is often unilateral in the absence of any systemic disease. We report a case of 54 year old male presenting with bilateral lipoma arborescens associated with osteoarthritis. The diagnosis is often difficult due to similar symptomatology of lipoma arborescens and osteoarthritis.

Keywords: Arthroscopy; Lipoma; Magnetic resonance imaging.

Fig. 1

Pre operative image showing swelling of both knees more on right side.

Fig. 2

Radiograph showing features of osteoarthritis and increased soft tissue shadow in suprapatellar region.

Fig. 3

Ultrasound examination of both knees revealing joint effusion, synovial proliferation and synovial projections (white arrow).

Fig. 4

Saggital and transverse section of MRI showing synovial proliferation (white arrows), joint effusion (red-black stars) and synovial projections (yellow arrows).

Fig. 5

Arthroscopic image showing multiple frond like projections and loss of cartilage in the medial and lateral compartment of knee.

Fig. 6

End point arthroscopic image showing underlying muscle after complete synovectomy in the supra patella pouch.

Fig. 7

Histopathological image revealing hyperplastic inflammed synovium (black arrow) and fibrous tissue along with adipose cells (black star).