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Polyarticular lipoma arborescens with inflammatory synovitis.
Mittermayer Santiago1, Antonio Sérgio Passos, Antonio Felipe Medeiros
1Department of Rheumatology, Escola Bahiana de Medicina e Saúde Pública, Salvador, Brazil. mitter@sn.com.br
Summary
Lipoma arborescens is a rare condition that can affect multiple joints, mimicking rheumatoid arthritis. Early recognition is crucial as it requires different treatment than typical inflammatory arthritis.
Area of Science:
- Rheumatology
- Orthopedics
- Radiology
Background:
- Lipoma arborescens is a rare, benign proliferation of synovial fat cells.
- It typically affects large joints like the knee, presenting as chronic joint swelling and pain.
Observation:
- A 29-year-old woman presented with a 12-year history of intermittent arthritis in multiple large joints.
- She had been treated for rheumatoid arthritis without benefit and had negative serological markers for inflammatory arthritis.
Findings:
- Magnetic resonance imaging revealed synovial hypertrophy and joint effusion, consistent with lipoma arborescens.
- Histopathology confirmed the diagnosis of lipoma arborescens.
- Arthroscopic synovectomy provided partial symptom relief.
Implications:
- Lipoma arborescens should be considered in patients with inflammatory arthropathy unresponsive to treatment, especially with negative rheumatoid factor and anti-CCP antibodies.
- Accurate diagnosis is essential as treatment differs significantly from rheumatoid arthritis.
- This case highlights the importance of advanced imaging and histopathology in diagnosing rare joint conditions.
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