PDF(Pubmed)
Abstract：
UNASSIGNED: Conditions mimicking tumors within the knee, such as arborescent lipoma and synovial chondromatosis, are generally benign yet closely linked to inflammatory or degenerative joint diseases. While each condition is commonly documented individually with osteoarthritis, their concurrent presentation within the same knee is extremely rare. This case report adheres to the SCARE 2023 guidelines (Sohrabi et al., 2023) and aims to shed light on the diagnostic and therapeutic challenges posed by the rare coexistence of these conditions, presenting unique management challenges.
METHODS: We detail the case of a 67-year-old woman who has been suffering from progressively worsening bilateral osteoarthritis for over five years, with significant impairment in her right knee. Symptoms included persistent pain unresponsive to standard treatments, reduced mobility, and recurrent swelling. A comprehensive diagnostic evaluation through clinical examination, radiography, and magnetic resonance imaging (MRI) suggested tricompartmental osteoarthritis complicated by suspected arborescent lipoma. Surgical exploration not only confirmed the presence of arborescent lipoma but also revealed synovial chondromatosis. Both conditions were validated during total knee arthroplasty via histopathological examination, and the patient demonstrated significant functional recovery 18 months postoperatively.
UNASSIGNED: The simultaneous occurrence of arborescent lipoma and synovial chondromatosis within an osteoarthritic knee emphasizes the complex nature of diagnosing and managing advanced joint pathologies. This case highlights the critical need for thorough diagnostic processes to differentiate between multiple potential diagnoses and the vital role of surgical intervention in managing such intricate conditions effectively.
CONCLUSIONS: The rare coexistence of arborescent lipoma and synovial chondromatosis in an osteoarthritic knee underlines the complexities of diagnosing and managing joint diseases. It accentuates the necessity of an exhaustive diagnostic approach and demonstrates the efficacy of surgical management in achieving favorable outcomes. This case supports the need for maintaining a broad differential diagnosis and underscores the value of interdisciplinary collaboration in managing complex joint pathologies.
METHODS: We detail the case of a 67-year-old woman who has been suffering from progressively worsening bilateral osteoarthritis for over five years, with significant impairment in her right knee. Symptoms included persistent pain unresponsive to standard treatments, reduced mobility, and recurrent swelling. A comprehensive diagnostic evaluation through clinical examination, radiography, and magnetic resonance imaging (MRI) suggested tricompartmental osteoarthritis complicated by suspected arborescent lipoma. Surgical exploration not only confirmed the presence of arborescent lipoma but also revealed synovial chondromatosis. Both conditions were validated during total knee arthroplasty via histopathological examination, and the patient demonstrated significant functional recovery 18 months postoperatively.
UNASSIGNED: The simultaneous occurrence of arborescent lipoma and synovial chondromatosis within an osteoarthritic knee emphasizes the complex nature of diagnosing and managing advanced joint pathologies. This case highlights the critical need for thorough diagnostic processes to differentiate between multiple potential diagnoses and the vital role of surgical intervention in managing such intricate conditions effectively.
CONCLUSIONS: The rare coexistence of arborescent lipoma and synovial chondromatosis in an osteoarthritic knee underlines the complexities of diagnosing and managing joint diseases. It accentuates the necessity of an exhaustive diagnostic approach and demonstrates the efficacy of surgical management in achieving favorable outcomes. This case supports the need for maintaining a broad differential diagnosis and underscores the value of interdisciplinary collaboration in managing complex joint pathologies.
摘要：
■模拟膝关节内肿瘤的条件，如树状脂肪瘤和滑膜软骨瘤病，通常是良性的，但与炎性或退行性关节疾病密切相关。虽然每种情况通常都有单独记录的骨关节炎，他们同时出现在同一膝盖内的情况极为罕见。本病例报告符合SCARE2023指南(Sohrabi等人。,2023年)，旨在阐明这些疾病罕见共存带来的诊断和治疗挑战，带来独特的管理挑战。
方法：我们详细介绍了一名67岁女性的病例，她的双侧骨关节炎逐渐恶化超过5年，她的右膝盖严重受损。症状包括对标准治疗无反应的持续性疼痛，流动性降低，和经常性的肿胀。通过临床检查进行全面的诊断评估，射线照相术,磁共振成像（MRI）提示三室骨关节炎合并可疑的树状脂肪瘤。手术探查不仅证实了树状脂肪瘤的存在，而且还发现了滑膜软骨瘤病。在全膝关节置换术期间通过组织病理学检查验证了这两种情况。患者在术后18个月表现出显著的功能恢复。
■骨关节炎膝关节内同时发生的树状脂肪瘤和滑膜软骨瘤病强调了诊断和管理晚期关节病变的复杂性。这种情况突出了彻底的诊断过程的关键需求，以区分多种潜在的诊断和手术干预在有效管理这种复杂的条件中的重要作用。
结论：骨关节炎性膝关节中罕见的树状脂肪瘤和滑膜软骨瘤病并存，突显了诊断和治疗关节疾病的复杂性。它强调了详尽的诊断方法的必要性，并证明了手术治疗在获得良好结果方面的有效性。此案例支持维持广泛的鉴别诊断的必要性，并强调了跨学科合作在管理复杂的关节病变中的价值。
方法：我们详细介绍了一名67岁女性的病例，她的双侧骨关节炎逐渐恶化超过5年，她的右膝盖严重受损。症状包括对标准治疗无反应的持续性疼痛，流动性降低，和经常性的肿胀。通过临床检查进行全面的诊断评估，射线照相术,磁共振成像（MRI）提示三室骨关节炎合并可疑的树状脂肪瘤。手术探查不仅证实了树状脂肪瘤的存在，而且还发现了滑膜软骨瘤病。在全膝关节置换术期间通过组织病理学检查验证了这两种情况。患者在术后18个月表现出显著的功能恢复。
■骨关节炎膝关节内同时发生的树状脂肪瘤和滑膜软骨瘤病强调了诊断和管理晚期关节病变的复杂性。这种情况突出了彻底的诊断过程的关键需求，以区分多种潜在的诊断和手术干预在有效管理这种复杂的条件中的重要作用。
结论：骨关节炎性膝关节中罕见的树状脂肪瘤和滑膜软骨瘤病并存，突显了诊断和治疗关节疾病的复杂性。它强调了详尽的诊断方法的必要性，并证明了手术治疗在获得良好结果方面的有效性。此案例支持维持广泛的鉴别诊断的必要性，并强调了跨学科合作在管理复杂的关节病变中的价值。
