S Amarjit Kataria, Budhiraja Shivali, Chandramouleeswari K, Anita S
Professor & Head, Goverment Medical College , Amritsar, Punjab, India .
J Clin Diagn Res. 2013 Aug;7(8):1708-9. doi: 10.7860/JCDR/2013/5692.3262. Epub 2013 Aug 1.
Intra-articular synovial lipomas are very rare and only few cases have been reported till now. We are reporting a rare case of a unilateral intra-articular lipoma of osteoarthritic knee joint in a 62 years old male. Patient had two episodes of sudden locking of knee joint, which resolved spontaneously. A plain X-ray showed changes which were suggestive of osteoarthritis. Clinically, patient was diagnosed as a case of loose bodies in left knee joint. An arthrotomy was performed. After a Histopathological Examination (HPE) of loose bodies, a diagnosis of an intra-articular synovial lipoma was made. Due to wide differentials and varied clinical behaviour of loose bodies, lipoma should be included in differential diagnosis of osteroarthritic patients who complain of episodic locking of knees. Intraarticular lipomas, on arthroscopic guided excision, get cured permanently, with no recurrence. The differentiation of an intra-articular lipoma from a relatively more common entity, Lipoma arborescens, has also been discussed.
关节内滑膜脂肪瘤非常罕见,迄今为止仅有少数病例报道。我们报告一例62岁男性骨关节炎膝关节单侧关节内脂肪瘤的罕见病例。患者膝关节有两次突然交锁发作,均自行缓解。X线平片显示提示骨关节炎的改变。临床上,患者被诊断为左膝关节游离体病例。遂行关节切开术。对游离体进行组织病理学检查(HPE)后,诊断为关节内滑膜脂肪瘤。由于游离体的鉴别诊断范围广泛且临床行为多样,对于主诉膝关节间歇性交锁的骨关节炎患者,脂肪瘤应纳入鉴别诊断。关节镜引导下切除关节内脂肪瘤可实现永久治愈,无复发。本文还讨论了关节内脂肪瘤与相对更常见的树枝状脂肪瘤的鉴别。