Synovial Hemangioma of knee

Clinical History

Recurrent swelling and pain of left knee with relapses and remissions. Limited range of movements during episodes

Imaging Findings

7-year-old male patient presented with 2 year history of recurrent knee pain and swelling with relapses and remissions. During episodes of pain patient has restricted movement of the joint and walks with a limp. Physical examination of the joint demonstrated restricted movement and a tender swelling around the knee. MRI of the knee showed a lobulated intraarticular mass with mixed signal on T1 weighted imaging and marked increased signal on T2 weighted imaging.

Discussion

Synovial hemangioma is a rare vascular malformation, occurring most frequently in the knee. The typical patient is a child or young adult presenting with a swollen and painful joint. Often they have relapses and remissions. They may also have atrophy of the adjacent muscles if the condition has been long standing. Diagnosis is sometimes difficult and often is only made postoperatively. Early diagnosis is important as recurrent hemarthrosis can lead to joint damage and eventual arthritis. MRI shows a lobulated intraarticular mass with mixed signal on T1 weighted imaging and marked increased signal on T2 – weighted imaging. Treatment includes open surgical resection with partial or total synoviectomy, arthroscopic excision, radiotherapy, cautery, use of sclerosing agents and laser arthroscopic ablation.

Differential Diagnosis List

Final Diagnosis

Synovial Hemangioma of knee

URL:	https://www.eurorad.org/case/6553
DOI:	10.1594/EURORAD/CASE.6553
ISSN:	1563-4086