J Korean Hip Soc.  2011 Mar;23(1):83-87. 10.5371/jkhs.2011.23.1.83.

Lipoma Arborescens in the Hip Joint: A Case Report

• Park JH
• Kim HS
• Chung ST
• Yoo JH
• Kim JH
• Cha SD
• Jung JH

• KMID: 2190781
• DOI: http://doi.org/10.5371/jkhs.2011.23.1.83

Abstract

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.

Keyword

Lipoma arborescens; Lipoma

MeSH Terms

Adipocytes
Arthralgia
Elbow Joint
Hip
Hip Joint
Inflammation
Joints
Knee Joint
Korea
Lipoma
Rare Diseases
Rheumatic Fever

Figure

• 

  Fig. 1 (A, B) Anteroposterior & axial Hip radiograph shows soft tissue density and bony erosion of the right femoral head.

• 

  Fig. 2 (A, B) Coronal & Axial T1-weighted MR image shows focal marrow edema and proliferative fatty mass of intermediate signal density in distended hip joint space.

• 

  Fig. 3 Images demonstrated uneven mild increased uptake diffuse increased uptake in right hip joint.

• 

  Fig. 4 (A) Intraoperative photograph shows pale, proliferating villi arising from synovial surface. (B) postoperative photograph showing the villous architecture of the synovium.

• 

  Fig. 5 Microscopic examination of the tumor reveals villous masses composed of mature adipocytes and lined by synovial cells (×40, inlet ×200).

Reference

1. Bryan RS, Dahlin DC, Sullivan CR. Lipoma of tendon sheath. J Bone Joint Surg Am. 1956. 38-A:1275–1280.

2. Edamitsu S, Mizuta H, Kubota K, Matsukawa A, Takagi K. Lipoma arborescens with hemarthrosis of the knee. A case report. Acta Orthop Scand. 1993. 64:601–602.

3. Armstrong SJ, Watt I. Lipoma arborescens of the knee. Br J Radiol. 1989. 62:178–180.

4. Hallel T, Lew S, Bansal M. Villous lipomatous proliferation of the synovial menbrane (lipoma arborescens). J Bone Joint Surg Am. 1988. 70:264–270.

5. Sheldon PJ, Forrester DM, Learch TJ. Imaging of intraarticular masses. Radiographics. 2005. 25:105–119.

6. Learch TJ, Braaton M. Lipoma arborescens: high-resolusion ultrasonographic findings. J Ultrasound Med. 2000. 19:385–389.

7. Kloen P, Keel SB, Chandler HP, Geiger RH, Zarins B, Rosenberg AE. Lipoma arborescens of the knee. J Bone Joint Surg Br. 1998. 80:298–301.

8. Martinez D, Millner PA, Coral A, Newman RJ, Hardy GJ, Butt WP. Case report 745: Synovial lipoma arborescens. Skeletal Radiol. 1992. 21:393–395.

9. Sola JB, Wright RW. Arthroscopic treatment for lipoma arborescens of the knee: a case report. J Bone Joint Surg Am. 1998. 80:99–103.