Peer-reviewed veterinary case report
How fat cells in joint fluid help diagnose synovial lipomatosis
By Agulla, Beatriz et al.·Published in Veterinary clinical pathology·2024·Department Medicina i Cirurgia Animals, Spain·View original on PubMed →
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Original publication title: Adipocytes in synovial fluid cytology: An approach for diagnosing synovial lipomatosis.
- Species:
- dog
Plain-English summary
A 2-year-old neutered male bullmastiff was brought in for chronic limping on his left hind leg. The vet found swelling in the knee and noticed changes on X-rays and MRI, including extra fluid in the joint and abnormal fat tissue. Tests on the joint fluid showed inflammation and a lot of fatty tissue, leading to a diagnosis of synovial lipomatosis, a rare condition where fat tissue grows in the joint lining. Surgery was performed to remove the affected tissue, which can help prevent future problems. The case highlights the importance of analyzing joint fluid to diagnose this condition effectively.
People also search for: dog limping left leg · bullmastiff joint swelling · synovial lipomatosis treatment · knee joint fluid analysis in dogs
Abstract
A 2-year-old neutered male bullmastiff dog was presented with chronic left hind limb lameness. Physical examination revealed left stifle effusion and medial buttress without cranial tibial thrust. Radiographs showed joint effusion and new bone formation at the patella apex. Magnetic resonance imaging showed increased synovial fluid, widening of the joint space, abnormal infrapatellar fat body and thinning of the cranial cruciate ligament. Synoviocentesis and cytologic evaluation of synovial fluid revealed marked mononuclear inflammation with abundant fatty tissue, suggesting synovial lipomatosis in conjunction with the imaging findings. The disease was confirmed histologically after sampling the lesion during arthrotomy. Synovial lipomatosis, characterized by extensive synovial adipose tissue proliferation of the synovial membrane, is a rare "tumor-like" disorder that usually affects the stifle. Although the etiology remains unclear, joint trauma, inflammation, instability, and lipid abnormalities have been proposed as causes. Inflammatory factors may promote synoviocyte and adipocyte hyperplasia that perpetuate the process. Surgical removal may be suggested to eliminate triggers and prevent future recurrences. The report provides the first cytological description of adipocytes in synovial fluid associated with the diagnosis of synovial lipomatosis in dogs. This case report underscores the potential effectiveness of cytologic analysis of synovial fluid smears, in combination with magnetic resonance imaging (MRI), for diagnosing this condition and reducing complications associated with arthrotomy for sampling purposes. Additionally, the case highlights that synovial lipomatosis should be considered as a potential differential diagnosis for synovial masses in dogs. Further cases are needed to validate these observations in veterinary medicine.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/38320970/