Letter to the Editor
Lipoma arborescens in Pediatric Knee. Nuclear Magnetic Resonance
Lipomatosis arborescens en rodilla pediátrica. Resonancia magnética nuclear
Maria Dolores Ruiz Montesinoa,
, Virginia Moreira Navarreteb, Carmen Vargas Lebrónb, Juan J. Rios-Martínc
Corresponding author
a Unidad de Gestión Clínica de Reumatología, Unidad de investigación (Imagen), Hospital Universitario Virgen Macarena, Sevilla, Spain
b Unidad de Gestión Clínica de Reumatología, Hospital Universitario Virgen Macarena, Sevilla, Spain
c Unidad de Gestión Clínica de Anatomía Patológica, Hospital Universitario Virgen Macarena, Sevilla, Spain
Read
5730
Timeswas read the article
1796
Total PDF
3934
Total HTML
Share statistics
array:24 [ "pii" => "S2173574317300436" "issn" => "21735743" "doi" => "10.1016/j.reumae.2016.07.006" "estado" => "S300" "fechaPublicacion" => "2017-05-01" "aid" => "948" "copyright" => "Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología" "copyrightAnyo" => "2016" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Reumatol Clin. 2017;13:180-1" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 625 "formatos" => array:3 [ "EPUB" => 55 "HTML" => 409 "PDF" => 161 ] ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S1699258X16300675" "issn" => "1699258X" "doi" => "10.1016/j.reuma.2016.07.002" "estado" => "S300" "fechaPublicacion" => "2017-05-01" "aid" => "948" "copyright" => "Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Reumatol Clin. 2017;13:180-1" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 3741 "formatos" => array:3 [ "EPUB" => 207 "HTML" => 2710 "PDF" => 824 ] ] "es" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Carta al Editor</span>" "titulo" => "Lipomatosis <span class="elsevierStyleItalic">arborescens</span> en rodilla pediátrica. Resonancia magnética nuclear" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "180" "paginaFinal" => "181" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Lipoma arborescens in pediatric Knee. Nuclear magnetic resonance" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figura 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 753 "Ancho" => 1001 "Tamanyo" => 141576 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Proliferación vellositaria sinovial. <span class="elsevierStyleItalic">Inset:</span> infiltración adiposa.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "M. Dolores Ruiz Montesino, Virginia Moreira Navarrete, Carmen Vargas Lebrón, Juan J. Rios-Martín" "autores" => array:4 [ 0 => array:2 [ "nombre" => "M. Dolores" "apellidos" => "Ruiz Montesino" ] 1 => array:2 [ "nombre" => "Virginia" "apellidos" => "Moreira Navarrete" ] 2 => array:2 [ "nombre" => "Carmen" "apellidos" => "Vargas Lebrón" ] 3 => array:2 [ "nombre" => "Juan J." "apellidos" => "Rios-Martín" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2173574317300436" "doi" => "10.1016/j.reumae.2016.07.006" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173574317300436?idApp=UINPBA00004M" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1699258X16300675?idApp=UINPBA00004M" "url" => "/1699258X/0000001300000003/v1_201704290027/S1699258X16300675/v1_201704290027/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S2173574317300448" "issn" => "21735743" "doi" => "10.1016/j.reumae.2016.06.003" "estado" => "S300" "fechaPublicacion" => "2017-05-01" "aid" => "946" "copyright" => "Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Reumatol Clin. 2017;13:181-2" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 598 "formatos" => array:3 [ "EPUB" => 52 "HTML" => 390 "PDF" => 156 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Cutaneous Leishmaniasis: An Opportunistic Infection" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "181" "paginaFinal" => "182" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Leishmaniasis cutánea. Una infección oportunista" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1044 "Ancho" => 950 "Tamanyo" => 155136 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Cutaneous leishmaniasis lesion in carpus (Oriental sore).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "María José Moreno Martínez, Manuel José Moreno Ramos, Paloma Sánchez Pedreño" "autores" => array:3 [ 0 => array:2 [ "nombre" => "María José" "apellidos" => "Moreno Martínez" ] 1 => array:2 [ "nombre" => "Manuel José" "apellidos" => "Moreno Ramos" ] 2 => array:2 [ "nombre" => "Paloma" "apellidos" => "Sánchez Pedreño" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S1699258X16300651" "doi" => "10.1016/j.reuma.2016.06.005" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1699258X16300651?idApp=UINPBA00004M" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173574317300448?idApp=UINPBA00004M" "url" => "/21735743/0000001300000003/v1_201705040052/S2173574317300448/v1_201705040052/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2173574317300023" "issn" => "21735743" "doi" => "10.1016/j.reumae.2016.02.010" "estado" => "S300" "fechaPublicacion" => "2017-05-01" "aid" => "892" "copyright" => "Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Reumatol Clin. 2017;13:178-9" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 741 "formatos" => array:3 [ "EPUB" => 64 "HTML" => 477 "PDF" => 200 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Images in Clinical Rheumatology</span>" "titulo" => "Hybrid SPECT/CT using 3D reconstruction with <span class="elsevierStyleSup">99m</span>Tc-HMPAO-labeled leukocytes in the diagnosis of an infectious process of unknown origin in foot" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "178" "paginaFinal" => "179" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "SPECT/TC con leucocitos autólogos marcados con <span class="elsevierStyleSup">99m</span>Tc-HMPAO y reconstrucción 3D híbrida en el diagnóstico de proceso infeccioso no filiado en pie" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1090 "Ancho" => 1600 "Tamanyo" => 131114 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Single photon emission computed tomography/computed tomography (SPECT/CT) after the intravenous administration of autologous leukocytes labeled with 20<span class="elsevierStyleHsp" style=""></span>mCi of <span class="elsevierStyleSup">99m</span>Tc-hexamethylpropyleneamine oxime (HMPAO). Hybrid SPECT/CT image (A) and SPECT image (B) showing the increased uptake in the fourth metatarsal of right foot. 3D reconstruction with bone window (C) that enables the correlation of the scintigraphic findings with the presence of a foreign body (arrow), that can be discerned by the impression it leaves on the surface of the skin (D).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Juan José Martín-Marcuartu, Víctor Manuel Pachón-Garrudo, Jose Antonio Lojo-Ramírez, Rosario García-Jiménez" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Juan José" "apellidos" => "Martín-Marcuartu" ] 1 => array:2 [ "nombre" => "Víctor Manuel" "apellidos" => "Pachón-Garrudo" ] 2 => array:2 [ "nombre" => "Jose Antonio" "apellidos" => "Lojo-Ramírez" ] 3 => array:2 [ "nombre" => "Rosario" "apellidos" => "García-Jiménez" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S1699258X16000413" "doi" => "10.1016/j.reuma.2016.02.010" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1699258X16000413?idApp=UINPBA00004M" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173574317300023?idApp=UINPBA00004M" "url" => "/21735743/0000001300000003/v1_201705040052/S2173574317300023/v1_201705040052/en/main.assets" ] "en" => array:15 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Lipoma arborescens in Pediatric Knee. Nuclear Magnetic Resonance" "tieneTextoCompleto" => true "saludo" => "To the Editor:" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "180" "paginaFinal" => "181" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Maria Dolores Ruiz Montesino, Virginia Moreira Navarrete, Carmen Vargas Lebrón, Juan J. Rios-Martín" "autores" => array:4 [ 0 => array:4 [ "nombre" => "Maria Dolores" "apellidos" => "Ruiz Montesino" "email" => array:1 [ 0 => "lruizmontesino@yahoo.es" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Virginia" "apellidos" => "Moreira Navarrete" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "Carmen" "apellidos" => "Vargas Lebrón" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "Juan J." "apellidos" => "Rios-Martín" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Unidad de Gestión Clínica de Reumatología, Unidad de investigación (Imagen), Hospital Universitario Virgen Macarena, Sevilla, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Unidad de Gestión Clínica de Reumatología, Hospital Universitario Virgen Macarena, Sevilla, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Unidad de Gestión Clínica de Anatomía Patológica, Hospital Universitario Virgen Macarena, Sevilla, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Lipomatosis <span class="elsevierStyleItalic">arborescens</span> en rodilla pediátrica. Resonancia magnética nuclear" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 753 "Ancho" => 1001 "Tamanyo" => 141576 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Villous proliferation in the synovium. <span class="elsevierStyleItalic">Inset:</span> adipose infiltration.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We report a case of <span class="elsevierStyleItalic">de novo</span> lipoma <span class="elsevierStyleItalic">arborescens</span> in a pediatric patient, in which nuclear magnetic resonance (NMR) was decisive in the diagnosis, ruling out other causes of monoarthritis.</p><p id="par0015" class="elsevierStylePara elsevierViewall">Lipoma <span class="elsevierStyleItalic">arborescens</span> is an uncommon benign tumor affecting synovial joints and bursae, that is characterized by the replacement of normal synovial tissue by mature fat cells, which provokes villous lipomatous proliferation. It is usually associated with synovitis.<a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">1,2</span></a> The cause is unknown and, although it has been reported in both adults and children, there are very few articles involving the latter.</p><p id="par0025" class="elsevierStylePara elsevierViewall">It typically affects the suprapatellar pouch of the knee joint and is, usually, monoarticular, although there are cases in which it is bilateral or occurs at another location like the elbow, ankle, wrist or hip.<a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">1,2</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">In most cases, it occurs <span class="elsevierStyleItalic">de novo</span>, but it is not that rare that it be associated with osteoarthritis, rheumatoid arthritis or an injury.<a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">1–4</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">The clinical signs include intermittent episodes of pain and joint inflammation with inconclusive laboratory findings and synovial fluid that shows no evidence of inflammation.<a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">1,2,5</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">Although plain radiography, ultrasound, arthrography and computed tomography can be of help, NMR is the best imaging technique for the diagnosis.<a class="elsevierStyleCrossRefs" href="#bib0075"><span class="elsevierStyleSup">6–9</span></a></p><p id="par0065" class="elsevierStylePara elsevierViewall">The recommended treatment is total synovectomy<a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">1,2,5</span></a> by arthrotomy or arthroscopy.</p><p id="par0075" class="elsevierStylePara elsevierViewall">Our patient was a 12-year-old girl with no significant previous medical history, except for a diagnosis of septic arthritis of the shoulder when she was 9. She had been treated with empirical antibiotic therapy and arthrotomy for drainage. There had been no signs of microorganisms in either the synovial fluid or blood cultures. All of the studies performed during her hospital stay were negative and all of the symptoms had completely disappeared.</p><p id="par0085" class="elsevierStylePara elsevierViewall">Three months before a follow-up visit, she noted progressive inflammation in her right knee, with occasional functional disability. She came to the emergency department, where she underwent arthrocentesis, which yielded a yellowish fluid with negative cultures, including Ziehl-Neelsen staining and culture on Löwenstein-Jensen medium. She was referred to rheumatology to be studied.</p><p id="par0095" class="elsevierStylePara elsevierViewall">She had no other symptoms or evidence of disease in a physical examination, except swelling of the knee, which was painless at that time, and there was only slight synovial effusion. Chest radiograph was normal, purified protein derivative (PPD) test was negative, complete blood count was normal, erythrocyte sedimentation rate 6<span class="elsevierStyleHsp" style=""></span>mm/h, urine analysis normal, C reactive protein 0.21<span class="elsevierStyleHsp" style=""></span>mg/L, antinuclear antibody test negative, rheumatoid factor 7<span class="elsevierStyleHsp" style=""></span>IU/mL, immunoglobulins normal, human leukocyte antigen (HLA)-B27 negative, and her celiac profile and α-1-acid glycoprotein were normal.</p><p id="par0105" class="elsevierStylePara elsevierViewall">We also took a plain radiograph of the knee, which was normal.</p><p id="par0115" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Ultrasound of the affected knee:</span> marked thickening of the synovium, especially in the suprapatellar recess, where it was accompanied by slight joint effusion. The synovial membrane showed, at some points, polypoid thickening that seemed to be floating in the middle of the effusion.</p><p id="par0125" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Right knee NMR</span>: there was a small Baker's cyst on the medial side of the popliteal fossa and a moderate joint effusion in the suprapatellar recess. In the middle of the effusion there was a marked thickening of the synovial membrane that gave it finger-like or polypoid images, and occupied the suprapatellar recess, Hoffa's fat pad and the part adjacent to the cruciate ligaments and menisci. These formations had a signal like that corresponding to fat. After the intravenous administration of the contrast medium, there was an enhancement marked by the synovium that surrounded the polypoid lesions. This image was the confirmation of lipoma <span class="elsevierStyleItalic">arborescens</span> (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0135" class="elsevierStylePara elsevierViewall">Ultimately, we decided to perform an NMR study of the patient's shoulder in view of the septic arthritis, and the result was normal.</p><p id="par0145" class="elsevierStylePara elsevierViewall">She was referred to an orthopedic surgeon for synovectomy, and the symptoms disappeared.</p><p id="par0155" class="elsevierStylePara elsevierViewall">Five months after the synovectomy, she noted inflammation in the left knee and functional disability. Nuclear magnetic resonance and ultrasound led to a diagnosis of lipoma <span class="elsevierStyleItalic">arborescens</span>.</p><p id="par0165" class="elsevierStylePara elsevierViewall">She underwent surgery, and the pathological study of the synovial membrane confirmed the diagnosis (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>).</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0175" class="elsevierStylePara elsevierViewall">Nuclear magnetic resonance can be highly useful in the evaluation of noninflammatory processes in patients with atypical monoarthritis.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Ruiz Montesino MD, Moreira Navarrete V, Vargas Lebrón C, Rios-Martín JJ. Lipomatosis <span class="elsevierStyleItalic">arborescens</span> en rodilla pediátrica. Resonancia magnética nuclear. Reumatol Clin. 2017;13:180–181.</p>" ] ] "multimedia" => array:2 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 921 "Ancho" => 800 "Tamanyo" => 113570 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Sagittal views; T2-weighted with contrast. Intra-articular fluid. Synovial hypertrophy with hyperintense areas that correspond to fat.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 753 "Ancho" => 1001 "Tamanyo" => 141576 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Villous proliferation in the synovium. <span class="elsevierStyleItalic">Inset:</span> adipose infiltration.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:9 [ 0 => array:3 [ "identificador" => "bib0050" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "From the archives of the AFIP: benign musculoskeletal lipomatous lesions" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "M.D. Murphey" 1 => "J.F. Carroll" 2 => "D.J. Flemming" 3 => "T.L. Pope" 4 => "F.H. Gannon" 5 => "M.J. Kransdorf" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1148/rg.245045120" "Revista" => array:6 [ "tituloSerie" => "Radiographics" "fecha" => "2004" "volumen" => "24" "paginaInicial" => "1433" "paginaFinal" => "1466" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15371618" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0055" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Intra-articular synovial lipoma of the knee joint (located in the lateral recess): a case report and review of the literature" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "K. Hirano" 1 => "M. Deguchi" 2 => "T. Kanamono" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.knee.2006.10.008" "Revista" => array:6 [ "tituloSerie" => "Knee" "fecha" => "2007" "volumen" => "14" "paginaInicial" => "63" "paginaFinal" => "67" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17127064" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0060" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Best cases from the AFIP: lipoma arborescens of the knees in a patient with rheumatoid arthritis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "J.P. Coll" 1 => "B.D. Ragsdale" 2 => "B. Chow" 3 => "T.C. Daughters" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1148/rg.312095209" "Revista" => array:6 [ "tituloSerie" => "Radiographics" "fecha" => "2011" "volumen" => "31" "paginaInicial" => "333" "paginaFinal" => "337" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21415182" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0065" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Bilateral lipoma arborescens associated with early osteoarthritis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "K. Al-Ismail" 1 => "W.C. Torreggiani" 2 => "F. Al-Sheikh" 3 => "C. Keogh" 4 => "P.L. Munk" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00330-001-1249-2" "Revista" => array:6 [ "tituloSerie" => "Eur Radiol" "fecha" => "2002" "volumen" => "12" "paginaInicial" => "2799" "paginaFinal" => "2802" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12386776" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0070" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Lipoma arborescens of knee joint: role of imaging" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "P.B. Patil" 1 => "M.G. Kamalapur" 2 => "S.K. Joshi" 3 => "S.K. Dasar" 4 => "R.V. Rao" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3941/jrcr.v5i3.602" "Revista" => array:6 [ "tituloSerie" => "J Radiol Case Rep" "fecha" => "2011" "volumen" => "5" "paginaInicial" => "17" "paginaFinal" => "25" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22470782" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0075" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Diagnostic imaging of lipoma arborescens" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S. Martín" 1 => "L. Hernández" 2 => "J. Romero" 3 => "J. Lafuente" 4 => "A.I. Poza" 5 => "P. Ruiz" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Skeletal Radiol" "fecha" => "1998" "volumen" => "27" "paginaInicial" => "325" "paginaFinal" => "329" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9677649" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0080" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "MR imaging of lipoma arborescens and the associated lesions" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "J.C. Vilanova" 1 => "J. Barceló" 2 => "M. Villalón" 3 => "J. Aldomà" 4 => "E. Delgado" 5 => "I. Zapater" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00256-003-0654-9" "Revista" => array:6 [ "tituloSerie" => "Skeletal Radiol" "fecha" => "2003" "volumen" => "32" "paginaInicial" => "504" "paginaFinal" => "509" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12811424" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0085" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "MR imaging of synovial tumors and tumor-like lesions" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "J.A. Narváez" 1 => "J. Narváez" 2 => "C. Aguilera" 3 => "E. de Lama" 4 => "F. Portabella" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s003300000759" "Revista" => array:6 [ "tituloSerie" => "Eur Radiol" "fecha" => "2001" "volumen" => "11" "paginaInicial" => "2549" "paginaFinal" => "2560" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11734958" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0090" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Imaging of intraarticular masses" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "P.J. Sheldon" 1 => "D.M. Forrester" 2 => "T.J. Learch" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1148/rg.251045050" "Revista" => array:6 [ "tituloSerie" => "Radiographics" "fecha" => "2005" "volumen" => "25" "paginaInicial" => "105" "paginaFinal" => "119" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15653590" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/21735743/0000001300000003/v1_201705040052/S2173574317300436/v1_201705040052/en/main.assets" "Apartado" => array:4 [ "identificador" => "8400" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Letters to the Editor" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21735743/0000001300000003/v1_201705040052/S2173574317300436/v1_201705040052/en/main.pdf?idApp=UINPBA00004M&text.app=https://reumatologiaclinica.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173574317300436?idApp=UINPBA00004M" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 7 | 13 | 20 |
| 2024 October | 67 | 29 | 96 |
| 2024 September | 71 | 10 | 81 |
| 2024 August | 77 | 31 | 108 |
| 2024 July | 85 | 31 | 116 |
| 2024 June | 94 | 27 | 121 |
| 2024 May | 77 | 25 | 102 |
| 2024 April | 81 | 19 | 100 |
| 2024 March | 82 | 29 | 111 |
| 2024 February | 58 | 19 | 77 |
| 2024 January | 66 | 25 | 91 |
| 2023 December | 60 | 26 | 86 |
| 2023 November | 53 | 25 | 78 |
| 2023 October | 81 | 33 | 114 |
| 2023 September | 92 | 44 | 136 |
| 2023 August | 64 | 12 | 76 |
| 2023 July | 89 | 23 | 112 |
| 2023 June | 75 | 34 | 109 |
| 2023 May | 68 | 21 | 89 |
| 2023 April | 50 | 6 | 56 |
| 2023 March | 64 | 20 | 84 |
| 2023 February | 67 | 24 | 91 |
| 2023 January | 43 | 34 | 77 |
| 2022 December | 98 | 30 | 128 |
| 2022 November | 61 | 30 | 91 |
| 2022 October | 92 | 35 | 127 |
| 2022 September | 65 | 26 | 91 |
| 2022 August | 69 | 44 | 113 |
| 2022 July | 54 | 32 | 86 |
| 2022 June | 65 | 32 | 97 |
| 2022 May | 75 | 32 | 107 |
| 2022 April | 54 | 50 | 104 |
| 2022 March | 62 | 44 | 106 |
| 2022 February | 68 | 34 | 102 |
| 2022 January | 76 | 40 | 116 |
| 2021 December | 52 | 44 | 96 |
| 2021 November | 52 | 36 | 88 |
| 2021 October | 62 | 46 | 108 |
| 2021 September | 45 | 49 | 94 |
| 2021 August | 40 | 34 | 74 |
| 2021 July | 42 | 29 | 71 |
| 2021 June | 45 | 20 | 65 |
| 2021 May | 78 | 50 | 128 |
| 2021 April | 125 | 84 | 209 |
| 2021 March | 73 | 33 | 106 |
| 2021 February | 59 | 15 | 74 |
| 2021 January | 59 | 26 | 85 |
| 2020 December | 42 | 24 | 66 |
| 2020 November | 74 | 23 | 97 |
| 2020 October | 34 | 13 | 47 |
| 2020 September | 52 | 24 | 76 |
| 2020 August | 30 | 21 | 51 |
| 2020 July | 31 | 18 | 49 |
| 2020 June | 37 | 15 | 52 |
| 2020 May | 33 | 18 | 51 |
| 2020 April | 30 | 19 | 49 |
| 2020 March | 19 | 5 | 24 |
| 2020 February | 2 | 0 | 2 |
| 2018 September | 0 | 1 | 1 |
| 2018 May | 4 | 1 | 5 |
| 2018 April | 31 | 7 | 38 |
| 2018 March | 68 | 7 | 75 |
| 2018 February | 33 | 10 | 43 |
| 2018 January | 25 | 5 | 30 |
| 2017 December | 26 | 16 | 42 |
| 2017 November | 29 | 9 | 38 |
| 2017 October | 24 | 11 | 35 |
| 2017 September | 23 | 8 | 31 |
| 2017 August | 16 | 8 | 24 |
| 2017 July | 29 | 26 | 55 |
| 2017 June | 50 | 26 | 76 |
| 2017 May | 48 | 24 | 72 |
| 2017 April | 2 | 2 | 4 |
Show all
