Bilateral synchronous involvement of knee and hip joints with primary lipoma arborescence in a young male

MRI of the knee and hip joints was performed using dedicated knee coil on 1.5 Tesla Philips MR Achieva, which revealed frond-like villous proliferation of the synovium in bilateral knee joint and suprapatellar compartment, which showed fatty signal on T1W (Figure 3A) and T2W image (Figure 3B) .There was complete loss of fatty signal from the villous projections on fat suppressed STIR images (Figure 3C and 3D). The most common anatomical location is the knee joint, specifically the suprapatellar pouch, although cases have been described in many other synovial joints like the hip, shoulder, elbow, wrist and ankle.2 Bilateral involvement is uncommon, but when bilateral joints are involved they usually occur at the same site.3 In very rare cases, LA has been reported to affect multiple joints.4 The exact etiology of this condition is unknown and most of the cases arise de novo. MRI is the modality of choice for this condition, which shows its characteristic imaging features and helps in ruling out the differential diagnosis. Since multiple joints can be involved screening of the other joints should be done for early diagnosis and management.