Lipoma Arborescens

 

Lipoma Arborescens MRI AxialLipoma Arborescens Knee Arthroscopy 1

 

Definition

 

Proliferative synovial condition

 

Characterised by synovial villi with central lipoma

 

Epidemiology

 

5th - 6th decade

Males

 

Clinical

 

Lipoma Arborescens

 

Most common in the knee

Usually monoarticular

Large effusion

 

Problems

 

Can lead to early degenerative change

 

Etiology

 

Unknown

 

MRI

 

Synovial proliferation

Signal similar to surrounding fat 

 

Lipoma Arborescens MRI AxialLipoma Arborescens MRI SagittalLipoma Arborescens OCD

 

Arthroscopy

 

Yellow brown polypoid / frond like villous synovitis

 

Lipoma Arborescens Knee ArthroscopyLipoma Arborescens Knee Arthroscopy 2

 

Histology

 

Subsynovial tissue replaced by mature adipocytes

 

Differential diagnosis

 

PVNS

Synovial Chondromatosis

 

Management

 

Synovectomy

 

Wang et al JBJS Rev 2019

- systematic review of 25 articles

- 71 knees in 65 patients undergoing arthroscopic synovectomy

- 3% recurrence rate

 

Kalifis et al J Orthop Surg Res 2022

- systematic review of 22 patients in 21 articles

- upper limb lipoma arborescens

- open and arthroscopic synovectomy

- no recurrence