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© 2007 by the American Institute of Ultrasound in Medicine
J Ultrasound Med 26:1427-1433 • 0278-4297

Case Series

Lipoma Arborescens of the Suprapatellar Bursa and Extensor Digitorum Longus Tendon Sheath

Report of 2 Cases

Efsun Senocak, MD, Kamil Gurel, MD, Safiye Gurel, MD, Kutay Engin Ozturan, MD, Husamettin Cakici, MD, Fahri Yilmaz, MD and Cetin Boran, MD

Departments of Radiology (E.S., K.G., S.G.), Orthopedics and Traumatology (K.E.O., H.C.), and Pathology (F.Y., C.B.), Abant Izzet Baysal University, Izzet Baysal School of Medicine, Gölköy, Turkey.

Address correspondence to Efsun Senocak, MD, Department of Radiology, Abant Izzet Baysal University, Izzet Baysal School of Medicine, 14280 Gölköy, Bolu, Turkey. E-mail: eurger{at}yahoo.com

Objective. Lipoma arborescens (diffuse articular lipomatosis) is a rare intra-articular lesion consisting of subsynovial villous proliferation of mature fat cells. The usual clinical presentation is painless swelling. The aim of this series was to emphasize the importance of gray scale and color Doppler sonography through the investigation of chronic joint swelling. Methods. Lipoma arborescens of the knee and extensor digitorum longus tendon sheath at the ankle region are described. The latter is extremely rare. We examined 2 patients with sonography before using cross-sectional modalities. Results. Gray scale sonography revealed hyperechoic irregular villous and frondlike projections within prominent joint effusion. A wavelike motion of the projections was shown by dynamic compression and manipulation of the effusion. We observed moderate vascularity on color Doppler sonography. Spectral analysis revealed a low-resistance arterial waveform. Conclusions. Gray scale sonography is a useful diagnostic modality that can be performed to evaluate chronic joint swelling before the use of cross-sectional and more expensive modalities.

Key Words: color Doppler sonography • lipoma arborescens • sonography • synovial membrane • tendons

Abbreviations: CT, computed tomography • ESR, erythrocyte sedimentation rate • LA, lipoma arborescens • MRI, magnetic resonance imaging • PVNS, pigmented villonodular synovitis • RF, rheumatoid factor • SC, synovial chondromatosis

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Copyright © 2007 by the American Institute of Ultrasound in Medicine.