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Lipoma Arborescens and Coexisting Psoriatic ArthritisA Case Report and Review of the Literature
Melissa A. Bent, MD1; Matthew Varacallo, MD1; Edward J. Fox, MD1; Sarah Voss, MD2; Elizabeth E. Frauenhoffer, MD2
1 Department of Orthopaedics and Rehabilitation, Penn State Milton S. Hershey Medical Center, 30 Hope Drive, Mail Code EC089, Hershey, PA 17033. E-mail address for M.A. Bent: melissa.a.bent@gmail.com
2 Department of Pathology, Penn State Milton S. Hershey Medical Center, 500 University Drive, Hershey PA 17033
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Investigation performed at the Departments of Orthopaedics and Rehabilitation and Pathology, Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania



Disclosure: None of the authors received payments or services, either directly or indirectly (i.e., via his or her institution), from a third party in support of any aspect of this work. One or more of the authors, or his or her institution, has had a financial relationship, in the thirty-six months prior to submission of this work, with an entity in the biomedical arena that could be perceived to influence or have the potential to influence what is written in this work. No author has had any other relationships, or has engaged in any other activities, that could be perceived to influence or have the potential to influence what is written in this work. The complete Disclosures of Potential Conflicts of Interest submitted by authors are always provided with the online version of the article.

Copyright © 2013 by The Journal of Bone and Joint Surgery, Inc.
JBJS Case Connector, 2013 Nov 27;3(4):e121 1-5. doi: 10.2106/JBJS.CC.M.00079
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Extract

Lipoma arborescens is a rare benign lesion characterized by villous lipomatous proliferation of the synovial membrane1-3. It is unclear whether it is inflammatory or neoplastic in origin. In 1953, Stout defined lipoma arborescens as a collection of fat beneath the synovial lining forming swollen villous projections4. While the etiology remains unknown, a non-neoplastic inflammatory origin is favored. It is well documented that the condition is often unilateral and that patients typically present with recurrent painless swelling of the affected joint(s)2,5. Bilateral cases involving the knee are rare6. Hoffa provided the first description in 19047. He described twenty-one patients with a bilateral inflammatory fibrous hyperplasia of articular adipose tissue with swelling around the patellar tendon. To the best of our knowledge, there have been six published case reports of bilateral involvement with associated psoriatic arthritis of these uncommon and unusual lesions3,6,8-11. Our case report supports an inflammatory etiology of lipoma arborescens. We present a forty-five-year-old man afflicted with bilateral lipoma arborescens of the knee with coexisting psoriatic arthritis. We also summarize the clinical, imaging, and histologic patterns for lipoma arborescens reported in the knee to help distinguish it from similar knee lesions. The patient was informed that data concerning the case would be submitted for publication, and he provided consent.
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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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