Lipoma Arborescens

 

Lipoma Arborescens Knee ArthroscopyLipoma Arborescens Knee Arthroscopy 1Lipoma Arborescens Knee Arthroscopy 2

 

Definition

 

Proliferative synovial condition

- characterised by synovial villi

- centre is lipoma

 

Clinical

 

Lipoma Arborescens

 

Most common in the knee

- massive synovial swelling

- large effusion

 

Problems

 

Can lead to early degenerative change

 

Aetiology

 

Unknown

- postulated to be related to minor knee trauma

 

Diagnosis

 

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

 

DDX

 

PVNS

Synovial Chondromatosis

 

Management

 

Options

 

1.  Arthroscopic Debridement

 

2.  Open Debridement

 

3.  Radionuclide Injection

- Yttrium 90

- not proven to work

- risk skin necrosis