CASE HISTORY – April 2023

Extremely rare joint disease Lipoma arborescens: a survey and a case report

Authors: Hendrik Rull, Pirja Sarap, Erik Tamp, Anne Poksi, Paul-Sander Vahi

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Lipoma aborescens is a rare slowly progressing chronic disease that affects the joints. LA manifests itself most commonly with episodic joint effusions. The most frequently affected joint is the knee, but the disease may occur in almost any medium or large joint. Today the diagnosis is based on typical findings on MRI, while other radiologic methods may also reveal the diagnostics. Arthroscopic total synovectomy is the most effective treatment. Intra-articular radiotherapy with Y90 has also demonstrated good results in reducing the symptoms.
Our case report presents a 56-year- old male who has had several recurrent knee joint effusions with no underlying cause. MRI showed specific alterations of Lipoma arborescens, such as villous and frond-like intra-articular fatty masses. The patient underwent arthroscopic total synovectomy and adjuvant radiosynovectomy. Twelve months later he was free of pain and demonstrated satisfactory motility of the affected knee joint.