Radiological Case: Bilateral Synchronous Involvement of Knee and Hip Joints With Primary Lipoma Arborescence in a Young Male

Ashwini Bakde Umredkar, MD; Amit Disawal, MD; Aarti Anand, MD; Prajwalit Gaur, MD; Jasdeep Kaur, MBBS


Appl Radiol. 2017;46(10):24-28. 

In This Article

Case Summary

A 28-year-old male presented to the orthopedic outpatient department with a three-year history of painless swelling in bilateral thighs and knees. He gave history of exacerbations and remission of the swelling and repeated knee joint aspiration for symptomatic relief, which revealed clear fluid. There was also history of dull pain in the left hip joint for which he had not taken medical advice.

The general physical examination revealed no significant abnormality. Local examination revealed swelling of bilateral suprapatellar region and knee joints (Figure 1A). There were no signs of acute inflammation. Fluctuation and patellar tap tests were positive on both sides.

Figure 1.

Clinical photograph (A) of the patient showing swelling in bilateral knee and suprapatellar region. Radiograph of both knee joints AP (B) and Lateral view (C) showing soft tissue swelling in the suprapatellar region. There are no bony erosions. Radiograph of the pelvis with hip joints (D) showing displacement of the fat stripes (gluteus minimus and iliopsoas) on left side suggestive of left hip joint effusion.

His laboratory tests complete blood count, HIV, HBsAg, C-reactive protein, ESR were normal. Rheumatoid factor was negative.