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Magnetic resonance imaging of lipoma arborescens explaining dry tap

Magnetic resonance imaging of lipoma arborescens explaining dry tap
Failed arthrocentesis due to chronic synovitis with lipoma arborescens in a patient with psoriatic arthritis. T1-weighted (left) and T2-weighted (right) axial images through the mid-pole of the patella show massive frond-like, fatty proliferation of the synovium both on the medial and lateral sides of the joint (thick arrows). Although a large joint effusion is present (E), placement of a needle, particularly from the medial side (arrow), would probably enter the hypertrophied synovium and would fail to yield fluid. Aspiration of 10 mL of low-viscosity, inflammatory fluid was achieved by the lateral approach.
L: lateral; M: medial.
Reproduced with permission from: Roberts WN, Hayes CW, Breitbach SA, Owen DS Jr. Dry taps and what to do about them: a pictorial essay on failed arthrocentesis of the knee. Am J Med 1996; 100:461.
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