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Lipoma arborescens

Case contributed by Ian Bickle
Diagnosis almost certain

Presentation

Teenager with juvenile chronic arthritis. Recurrent knee effusion with a bloody knee aspirate.

Patient Data

Age: 18 years
Gender: Female
mri

Knee effusion.

Synovial thickening with extensive frond-like projections.

These exhibit fatty signal on the MR sequences.

Illustration of the frond like appearances in the joint space.

Image courtesy of Frank Gaillard.

Case Discussion

Lipoma arborescens is a  condition affecting synovial linings of the joints and bursae, with 'frondlike' depositions of fatty tissue.

The macrospic frondlike appearance was felt to resemble a tree in leaf; hence, the Latin term arborescens (meaning “tree-forming” or “treelike”).

It is most often observed in those over 50 years or age with recurrent effusions, most commonly in the knee, but can occur in rarer circumstances, such as collagen vascular disorders.

This 18 year-old female suffered from juvenile chronic arthritis (JCA) with recurrent effusions which were blood stained on aspiration.

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