This 60-year-old male presents with left shoulder pain. The key areas of focus in this case have been highlighted.
Q1 – What is the most likely diagnosis of the intraarticular mass? For clues, you can also check out this case: Upon checking out the joint, we found lots of bodies
A1 – Lipoma arborescens.
Lipoma arborescens is an uncommon condition of the synovial lining of the joints and bursae with frond-like deposition of fatty tissue. Patients typically present in the 5th through 7th decades. The most common site of involvement is the suprapatellar bursa of the knee. However, other joints may be infected including the hip, shoulder, wrist, and elbow. Histologically, the normal synovium is replaced by hypertrophic villi demonstrating deposition of mature lipocytes. MRI is the modality of choice for diagnosis of these lesions which follow signal intensity of fat on all sequences.
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