Intra-articular nodular fasciitis of the knee: a rare cause of recurrent hemarthrosis

Abstract

A 20-year-old man presented with pain and recurrent hemarthrosis in the right knee. Magnetic resonance imaging of the knee showed a lesion with homogeneous low signal intensity on T1-weighted images and a heterogeneous, low to high signal intensity on T2-weighted images. At arthroscopy, the mass was located between the posterior cruciate ligament and the posterior knee joint capsule. The tumor was excised through a posterior approach and histologically diagnosed as a nodular fasciitis. Intra-articular nodular fasciitis is a very rare clinicopathologic entity. The current case showed the unique clinical feature of recurrent hemarthrosis at initial presentation, which has not been previously reported.

Nodular Fasciitis

“…There were no morphologic differences seen in the lesions based on the location, as previously described. In addition, there was no intra‐osseous or intra‐articular extension of the lesions, as described in other publications 11 , 16 – 18 …”

“…Sonograms were acquired with high-frequency linear array (12)(13)(14)(15)(16)(17) MHz) transducers on clinical ultrasound machines (LOGIQ 9; GE Healthcare, Wauwatosa, WI; and HDI 5000 and iU22; Philips Healthcare, Bothell, WA) as part of routine patient care. Magnetic resonance images were acquired on a clinical 1.5-T system (Signa Excite; GE Healthcare).…”

Intra-Articular Nodular Fasciitis of the Knee: A Case Report of MRI Findings

“…Although information on imaging studies for intra-articular nodular fasciitis is limited, the current case showed nonspecific findings on MRI images, with homogeneous iso to low signal intensity on T1-weighted images and a heterogeneous, low to high signal intensity on T2-weighted images as reported previously (3)(4)(5)(6)(7). In this present case, conventional MRI with no contrast study showed nonspecific signal intensity of the lesion similar to previous reports, resulting in difficulty in making a precise pre-operative diagnosis on MRI.…”

Nodular fasciitis causing progressive limitation of knee flexion in a marathon runner: Imaging with ultrasound and magnetic resonance

“…Nodular fasciitis is a benign, subcutaneous tumor‐like lesion caused by myofibroblastic proliferation, and is usually found on the upper limbs, trunk, head, and neck [1–3]. Intra‐articular nodular fasciitis is rarely reported.…”

“…Intra‐articular nodular fasciitis is rarely reported. It is difficult for clinicians to differentiate nodular fasciitis from other tumor‐like lesions solely by imaging [3]. Because of the possibility of malignancy, such as malignant fibrous histiocytoma [2], surgical exploration is required for confirmation of pathology.…”