RESUMO
O lipoma arborescente é uma causa incomum de lesão intra-articular que se apresenta como aumento de volume articular indolor, lentamente progressivo, que persiste por muitos anos e é acompanhado por derrames articulares intermitentes. O envolvimento de sítios extra-articulares é incomum, mas pode ocorrer em bainhas tendíneas e bursas. A ressonância magnética é o melhor exame para o diagnóstico, embora a biópsia sinovial possa ser necessária em alguns casos. Relatamos três casos com o objetivo de destacar o espectro clínico da doença, as características da imagem e a resposta ao tratamento imunossupressor.
Lipoma arborescens 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. Extra-articular site(s) involvement is unusual, but can occur in tendon sheaths and bursas. Magnetic resonance imaging is the best diagnostic exam, although synovial biopsy may be necessary. We report three cases in order to highlight the clinical spectrum and imaging features of the disease, so that early diagnosis and appropriate treatment can be given.
Assuntos
Humanos , Masculino , Feminino , Adulto , Sinovite , Traumatismos do Joelho , Lipoma , Artrite , Membrana Sinovial , Imageamento por Ressonância Magnética , Adipócitos , Sinovectomia , ArticulaçõesRESUMO
Lipoma arborescens or synovial lipomatosis is a rare disorder that is characterized by mature fat infiltration of the hypertrophic synovial villi, most frequently affecting the supra-patellar pouch of the knee. This paper presents a case of lipoma arborescens of the ankle joint bilaterally in an adult patient with involvement of both the intra-articular synovium and the synovial sheath of the tendons around the ankle.
Assuntos
Adulto , Humanos , Articulação do Tornozelo , Tornozelo , Joelho , Lipoma , Lipomatose , Imageamento por Ressonância Magnética , Membrana Sinovial , TendõesRESUMO
@#Lipoma arborescens is a non-neoplastic, reactive condition due to chronic synovial inflammation and irritation, characterized by frond-like or villous proliferation of mature adipose tissue covered by hyperplastic synovium. The knee is the most commonly affected site particularly the suprapatellar pouch. We report a case of lipoma arborescens affecting the right knee of an elderly Chinese gentleman associated with bilateral knee and hand osteoarthritis. He presented with progressive worsening of right knee swelling and pain. Partial synovectomy of the right knee was performed and no lesion recurrence was noted at one year post-operation. The clinical and imaging findings, pathological features, together with differential diagnoses were discussed.
RESUMO
RESUMOLipoma arborescens (LA) é definido como uma proliferação vilosa lipomatosa da membrana sinovial com substituição difusa do tecido sinovial por células gordurosas maduras. A lesão é muito rara, envolve a articulação do joelho (região suprapatelar) e se associa a doenças articulares degenerativas. Descrevemos o caso de um paciente de sexo masculino, portador de espondilite anquilosante com quadro de monoartrite de joelho direito e aumento de volume importante na região suprapatelar. O diagnóstico de lipoma arborescens foi confirmado a partir da ressonância magnética do joelho direito.
ABSTRACTLipoma 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.
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Articulação do Joelho , Lipoma/complicações , Espondilite Anquilosante/complicaçõesRESUMO
Relato de caso de um paciente do sexo feminino de 26 anos que apresentava queixas de dores eventuais e episódios recorrentes de derrame articular no joelho esquerdo havia aproximadamente 10 anos. Após anamnese, exame físico, exames radiográficos e exames de imagem por ressonância magnética foi firmado o diagnóstico de lipoma arborescente de joelho. A paciente foi submetida a tratamento artroscópico para ressecção da lesão. No pós-operatório foi encaminhada para reabilitação fisioterápica, com boa evolução.
Case report of a female patient of 26 years who complained of pain and recurrent episodes of joint swelling in his left knee about 10 years ago. After anamnesis, physical examination and radiographic imaging and magnetic resonance were diagnosed with arborescent lipoma of the knee, and the patient underwent arthroscopic treatment for resection of the lesion. Postoperatively the patient was referred to physical therapy rehabilitation with good evolution.
Assuntos
Humanos , Feminino , Adulto Jovem , Joelho , Lipoma , Membrana SinovialRESUMO
Lipoma arborescens is a very rare disease in which adipocytes form a synovial villous lipoma. In addition, it has the potential for dysplastic proliferation. Hypertrophic synovial lipoma is stimulated by movement of joints, which results in joint pain, effusion, limitation of joint movement and swelling. A definite cause has not yet been proven, but trauma, rheumatic arthritis, inflammation and degenerative change are believed to be possible causes. There have been reports of lipoma arborescens in several joints, including the knee joint and elbow joint. However, it is very rare to find this disease in hip joints. In fact, only one such case has been reported in Korea. We report here on a rare case of lipoma arborescens in the hip joint along with a review of the relevant literature.
Assuntos
Adipócitos , Artralgia , Articulação do Cotovelo , Quadril , Articulação do Quadril , Inflamação , Articulações , Articulação do Joelho , Coreia (Geográfico) , Lipoma , Doenças Raras , Febre ReumáticaRESUMO
Lipoma Arborescens é uma lesão intra-articular rara e benigna, de etiologia desconhecida, caracterizada por proliferação vilosa sinovial e substituição do tecido subsinovial por tecido gorduroso maduro. Essa condição faz parte dos diagnósticos diferenciais no caso de uma articulação lenta, progressiva e cronicamente edemaciada. Apresentamos um caso de envolvimento bilateral em joelhos e discutimos sintomas, diagnóstico e tratamento dessa doença.
Lipoma Arborescens is a rare, benign, intra-articular lesion, of unknown etiology, characterized by villous proliferation of the synovium and diffuse replacement of the subsynovial tissue by mature fat cells. It forms part of the differential diagnosis for a slowly progressive chronically swollen joint. We present a case of bilateral involvement of the knees and discuss the symptoms, diagnosis and treatment of this condition.
Assuntos
Humanos , Masculino , Adulto , Joelho , Traumatismos do Joelho , Lipoma , Lipomatose , Espectroscopia de Ressonância Magnética , Membrana SinovialRESUMO
Lipoma arborescens is a villous proliferation of fatty tissue in the synovial membrane, and known causes are trauma, meniscal injury, inflammation, infection, degenerative change, tumor, and so forth. The reported cases are extremely rare. We report a case of lipoma arborescens developed in all compartments of the knee joint, and treated well with arthroscopic surgery.
Assuntos
Tecido Adiposo , Artroscopia , Inflamação , Articulação do Joelho , Joelho , Lipoma , Membrana SinovialRESUMO
This report describes a patient with lipoma arborescens presenting as hemarthrosis of a knee with intraosseous lesions. A 44-year old woman complained of pain and swelling of left knee. Arthrocentesis resulted in bloody effusion. Magnetic resonance images showed villous projecting frondlike fatty soft tissue proliferation in the suprapatellar pouch and ovoid intraosseous lesions in proximal tibia. The soft tissue mass was removed through arthroscopic synovectomy and the biopsy of the mass confirmed the diagnosis. The intraosseous lesions were not considered as a cause of hemarthrosis. We failed to find the exact cause of hemarthrosis. The patient remained asymptomatic after removal of the mass for 10 months. As far as we know, this is the first report of hemarthrosis associated with lipoma arborescens in korea.
Assuntos
Adulto , Feminino , Humanos , Biópsia , Diagnóstico , Hemartrose , Joelho , Coreia (Geográfico) , Lipoma , TíbiaRESUMO
Lipoma arborescens is a rare intra-articular lesion characterized by villous lipomatous proliferation of the synovial tissue, usually found in knee. Patients with this benign condition are seen with progressive, painless swelling of the joint. We presented a case of 35 year old man with 3 year history of painless swelling in right knee. The symptom waxed and waned having about 1 year interval. The swelling was not related to alcohol intake and walking. Physical examination revealed severe effusion in right knee. The active range of motion was full and patient explained some tenderness on lateral side of patello-femoral joint. There were no abnormalities in knee X-ray but magnetic resonance image revealed a villous proliferation in suprapatella pouch. There were no significant abnormalities in blood test. Joint fluid analysis did not reveal any cause of swelling and effusion. In evaluation of isokinetic exercise, there was significant weakness of knee extensors.
Assuntos
Adulto , Humanos , Testes Hematológicos , Articulações , Joelho , Lipoma , Exame Físico , Amplitude de Movimento Articular , CaminhadaRESUMO
Lipoma arborescens is a rare intra-articular lesion consisting of a villous lipomatous proliferation of the synovial lining. We experienced one case of lipoma arborescens of knee which was associated with avascular necrosis of femoral head. This case report draws the attention to history, physical findings, MR images, pathologic findings and arthroscopic appearance of this rare lesion. Arthro;copically, the lesion appears as a synovial lesion with numerous fatty-appearing globules and villous projections. Although the etiology is unknown, lipoma arborescens has been described in association with osteoarthritis, rheumatoid arthritis and diabetes mellitus. MR imaging is diagnostic choice to differentiate the lesion from rheumatoid arthritis, pigmented villonodular synovitis and synovial chondromatosis in those patients who present with chronic, swollen and painfui joint. Arthroscopic removal was effective in this case and we think that treatment choice of this lesion is arthroscopic removal.
Assuntos
Humanos , Artrite Reumatoide , Condromatose Sinovial , Diabetes Mellitus , Cabeça , Articulações , Joelho , Lipoma , Imageamento por Ressonância Magnética , Necrose , Osteoartrite , Sinovite Pigmentada VilonodularRESUMO
Lipoma arborescens is a rare intra articular lesion consisting of a villous lipomatous proliferation of the synovial lining and occurs mainly in the knee joint. It is mostly found in older patients with joint trauma, meniscal lesions or chronic synovitis. The authors describe one case of a 29-year-old male with multiple lipomas in the right knee joint who has a history of joint trauma. He had joint effusion, pain, giving way and restricted terminal extension of the right knee. Histology and gross findings are consistent with the lipoma arborescens. After arthroscopic excision of the masses, symptom was relieved completely and the patient had gained full range of motion of the right knee joint.