SYNOVIAL LIPOMATOSIS IN A 36-YEAR-OLD FEMALE WITH CHRONIC LEFT KNEE PAIN AND MECHANICAL SYMPTOMS

Sayf Aldeen Kassab Bashi¹, Moamer Abdulghafoor Ibrahim², Ahmed Salih Alshewered³

 

1 – Department of Orthopedics, Mosul General Hospital, Nineveh Health Directorate, Ministry of Health. Mosul, Iraq.

2 – University of Mosul. Mosul, Iraq.

3 – Misan Radiation Oncology Center, Misan Health Directorate, Ministry of Health. Misan, Iraq.

Synovial 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.

 

Keywords: orchiopexy, synovial lipomatosis, knee arthroscopy, lipoma arborescens, arthroscopy, knee pain.

 

Corresponding author: Ahmed Salih Alshewered, e-mail: Этот e-mail адрес защищен от спам-ботов, для его просмотра у Вас должен быть включен Javascript

For citation: Sayf Aldeen Kassab Bashi, Moamer Abdulghafoor Ibrahim, Ahmed Salih Alshewered. Synovial lipomatosis in a 36-year-old female with chronic left knee pain and mechanical symptoms. REJR 2026; 16(1):237-242. DOI: 10.21569/2222-7415-2026-16-1-237-242.

Received: 08.09.25 Accepted:            15.10.25