Department of Radiology, Mayo Clinic, Rochester, MN, USA.
Clin Radiol. 2013 Dec;68(12):1220-6. doi: 10.1016/j.crad.2013.07.002. Epub 2013 Aug 19.
To determine whether the aetiology differed between typical cases of lipoma arborescens with unilateral knee involvement and atypical cases involving joints other than the knee, polyarticular disease, and disease outside of the knee joint.
Cases of lipoma arborescens involving the knee joint were evaluated for the distribution of the disease and severity of degenerative arthritis. Joints other than the knee were evaluated for the presence and severity of degenerative arthritis, and the distribution was classified as either intra-articular, extra-articular, or both. Clinical history was reviewed for patient age at presentation, a history of inflammatory arthritis, diabetes mellitus, and known steroid use. Fisher's exact test was used to determine whether there was a statistically significant difference between typical and atypical presentations of the disease.
Lipoma arborescens was identified in 45 joints in 39 patients. Twenty-eight patients were classified as "typical" and 11 patients had "atypical" disease. There was no significant difference in age at presentation, presence of degenerative arthritis, or known inflammatory arthritis when comparing typical and atypical presentations of the disease.
Twenty-eight percent of patients in the present study had atypical presentation of lipoma arborescens with multifocal lipoma arborescens or disease in joints other than the knee. There was no significant difference in age at presentation, presence of degenerative arthritis, or known inflammatory arthritis when comparing typical and atypical presentations of the disease. Of the 39 patients, only three had no evidence of degenerative arthritis, which suggests that many cases of lipoma arborescens are secondary to chronic reactive change in association with degenerative arthritis.
确定单侧膝关节受累的典型树枝状脂肪瘤病例与非膝关节受累、多关节疾病和膝关节外病变的非典型病例的病因是否不同。
评估膝关节内树枝状脂肪瘤病例的疾病分布和退行性关节炎严重程度。评估膝关节外关节是否存在退行性关节炎及其严重程度，并将分布分类为关节内、关节外或两者兼有。回顾患者的临床病史，包括发病时的年龄、炎症性关节炎史、糖尿病和已知的类固醇使用情况。采用 Fisher 确切检验确定疾病的典型和非典型表现之间是否存在统计学显著差异。
在 39 名患者的 45 个关节中发现了树枝状脂肪瘤。28 名患者被归类为“典型”，11 名患者为“非典型”疾病。在比较疾病的典型和非典型表现时，在发病年龄、存在退行性关节炎或已知炎症性关节炎方面没有显著差异。
在本研究中，28%的患者存在多灶性树枝状脂肪瘤或膝关节外关节病变的非典型树枝状脂肪瘤表现。在比较疾病的典型和非典型表现时，在发病年龄、存在退行性关节炎或已知炎症性关节炎方面没有显著差异。在 39 名患者中，只有 3 名患者没有退行性关节炎的证据，这表明许多树枝状脂肪瘤病例是与退行性关节炎相关的慢性反应性变化的结果。
