Question:

The following conditions are differential diagnosis for lipoma arborescens with their differentiating finding. Pick the false combination:
1. Synovial lipoma - Polyp like round to oval mass.
2. Pigmented Villo Nodular Synovitis -lobulated mass with increased signal intensity on T1 and T2 weighted images.
3. Synovial Chondromatosis- Joint Effusion with heterointense intraarticular bodies.
4. Synovial Hemangiomas- Hyperintense to subcutaneous fat.
5. Rheumatoid arthritis -Joint space narrowing with intermediate to low signal intensity pannus.





Answer:

The correct answer for the question "The following conditions are differential diagnosis for lipoma arborescens with their differentiating finding. Pick the false combination:" is:

2. Pigmented Villo Nodular Synovitis -lobulated mass with increased signal intensity on T1 and T2 weighted images.



Explanation
a) [Intra-articular synovial lipoma appears as a small, single, polyp like mass, round to oval in shape with a short stalk.]

b) [Presents as a lobulated mass with reduced signal intensity on T1 and T2 weighted images due to hemosiderin.]

c) [Associated with effusion and adjacent erosions. The signal intensity of intra articular bodies varies depending on the amount of cartilage or bones present.]

d) [Shows intermediate signal intensity on T1 weighted sequences and appear hyperintense more than subcutaneous fat on T2 and fat saturated sequences.]

e) [The pannus appears as intermediate to low signal intensity on T1 and T2 weighted images. Other findings like, joint space narrowing, erosions, intraarticular loose (rice) bodies may be seen.]



From the manuscript:
Lipoma Arborescens of Knee Joint: Role of Imaging
Radiology Case. 2011 Nov; 5(11):17-25


This article belongs to the MSK section.




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From the manuscript

Lipoma Arborescens of Knee Joint: Role of Imaging

Free full text article: Lipoma Arborescens of Knee Joint: Role of Imaging

Abstract
A 23 year old Asian female presented with swelling of right knee joint for 5 years with history of exacerbations and remissions of symptoms. She was initially diagnosed as a case of suprapatellar bursitis based on clinical and X-ray findings. Further evaluation with higher imaging modalities was pathognomonic of lipoma arborescens. Patient underwent synovectomy and the diagnosis was confirmed histologically. We describe a histologically proven case of lipoma arborescens to highlight the imaging findings on X-ray, Ultrasound and Magnetic resonance imaging with arthroscopic correlation. The unique feature of this case report is multimodality imaging correlation with arthroscopy and histopathology findings. We have highlighted the pathognomonic imaging findings of this rare but benign intra-articular lesion and also discussed the differential diagnosis in detail.






References



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