Musculoskeletal synovial abnormalities and treatmentsAutoimmune and Inflammatory Disorders ResearchInflammatory Myopathies and Dermatomyositis

Sayf Aldeen Kassab Bashi, Moamer Abdulghafoor Ibrahim, A. Alshewered

2026.1.1Russian Electronic Journal of Radiology

DOI: 10.21569/2222-7415-2026-16-1-237-242

Abstract

ynovial lipomatosis, or lipoma arborescens, is a rare, benign intra-articular disorder characterized by diffuse villous proliferation of synovial tissue due to fatty infiltration.This condition often presents with nonspecific symptoms such as chronic knee pain, intermittent swelling, and mechanical dysfunction, including locking.Materials and methods.Herein, we present the case of a 36-year-old female with chronic left knee pain, intermittent swelling, and episodes of locking.Results.Magnetic resonance imaging (MRI) suggested intra-articular pathology, which was confirmed by histopathological examination after arthroscopy and biopsy.The patient underwent arthroscopic synovectomy.Postoperatively, she was satisfied with her outcome, with improved pain relief and function in her right knee.Discussion.In this case, the patient presented with chronic knee pain, intermittent swelling, and occasional mechanical locking, which are hallmark symptoms of intra-articular pathology.However, the imaging findings, including MRI and ultrasound, were insufficient to establish a definitive diagnosis.MRI is typically considered the gold standard for diagnosing synovial lipomatosis due to its ability to visualize the characteristic villous synovial projections with fatty infiltration, which appear hyperintense on T1-and T2-weighted images and suppress on fat-saturated sequences [2].Ultrasound, while being a more accessible and cost-effective modality, is often limited in its ability to provide clear differentiation from other synovial pathologies such as pigmented villonodular synovitis (PVNS), synovial chondromatosis, or rheumatoid synovitis.In this case, the imaging findings were nonspecific, highlighting the diagnostic challenges in identifying synovial lipomatosis without histopathological correlation.Conclusion.This case report highlights the clinical manifestations, diagnostic challenges, and therapeutic options for synovial lipomatosis, emphasizing the importance of early recognition and timely intervention.

Citation format

BASHI, Sayf Aldeen Kassab; IBRAHIM, Moamer Abdulghafoor; ALSHEWERED, A. SYNOVIAL LIPOMATOSIS IN a 36-YEAR-OLD FEMALE WITH CHRONIC LEFT KNEE PAIN AND MECHANICAL SYMPTOMS. Russian Electronic Journal of Radiology, 2026, 16(1): 237–242.