Synovial Hemangioma in the Knee: MRI Findings

Abstract

Synovial hemangiomas are rare benign tumors of vascular origin. A 23-year-old boy presented with knee pain and swelling. The boy had developed symptoms 18-months earlier. He was diagnosed with synovial hemangioma based on magnetic resonnance imaging examination and histopathologic findings of the arthroscopic biopsy tissue. We present the magnetic resonance imaging and histopathologic findings of synovial hemangioma of the knee.

Intra-articular Synovial Hemangioma: A Rare Cause of Knee Pain and Swelling

“…It presents as recurrent swelling of the knee and intermittent pain (depending on the presence of hemarthrosis). [ 11 - 13 ] In our case, the symptoms were traced back 6 months earlier. Other than pain and mild swelling in the knee, there were no specific symptoms and signs.…”

“…MRI is the best modality for evaluation of intra-articular soft-tissue lesions and should be considered as the diagnostic method of choice. [ 11 ] MRI detects the tumor size and extent, and if any chondral degeneration present. [ 2 , 3 , 11 , 14 ] Published studies have detailed the MRI features of synovial hemangioma as an intra-articular lobulated mass which can cause cortical bone erosions.…”

“…[ 11 ] MRI detects the tumor size and extent, and if any chondral degeneration present. [ 2 , 3 , 11 , 14 ] Published studies have detailed the MRI features of synovial hemangioma as an intra-articular lobulated mass which can cause cortical bone erosions. The lesion usually shows low to iso-intensity signal on T1 sequences, high signal intensity with hypo intense septae or spots within the lesion on T2-weighted and fat-suppressed images.…”

“…Regarding PVNS, it usually shows intermediate signal on T1WI, low signal on T2WI with areas of high signal due to inflamed synovium or joint fluid, and variable enhancement on contrast-enhanced T1WI. It also can cause hemorrhage which can be bright on fat saturated images [ 11 , 15 ] and it is possible for changes in hemoglobin or hematoma over time to produce a relatively higher intensity of the lesion on T1WI. [ 21 ]…”

Location, Clinical Presentation, Diagnostic Algorithm and Open vs. Arthroscopic Surgery of Knee Synovial Haemangioma: A Report of Four Cases and a Literature Review

“…Our other three cases were local sessile intra-articular SH located near the superior pole of the patella, by far the most frequent location in the anterior compartment of the knee ( 5 – 8 , 19 , 21 , 24 , 27 – 29 , 38 , 40 , 42 , 44 , 50 , 53 – 57 ), followed by the infrapatellar fat pad ( 11 , 18 , 23 , 30 , 45 , 59 ), the posterior compartment, the medial compartment ( 2 – 4 , 25 , 35 , 39 , 42 , 54 , 61 ) and the intercondylar notch ( 22 , 43 , 46 , 47 , 54 ). The three reported patients with KSH near the superior pole of the patella had the rare phenomenon of bone erosion, which was localized in the patella in two cases, a previously undescribed location for KSH bone erosion, and in the supratrochlear cortical bone in one case.…”