Synoviales Hämangiom als seltene Ursache eines Hämarthros

Reutter, G.; Klug, Stefanie J.; Rompel, Oliver

doi:10.1007/s001120050742

Cited by 5 publications

(1 citation statement)

References 15 publications

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“…A whole body examination focusing on the musculoskeletal system can reveal other arthritic joints making synovial hemangioma unlikely. A thorough skin inspection is mandatory, as cutaneous hemangiomas can be seen in up to 40% of patients with synovial hemangiomas [19,23,24]. Radiologic imaging techniques should include (Doppler)-ultrasound and dynamic contrast-enhanced thin section MRI and, most important, requests of these examinations should be specified due to the differential diagnosis of synovial hemangioma.…”

Section: Discussionmentioning

confidence: 99%

Mimicry of lyme arthritis by synovial hemangioma

et al. 2009

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To report on the differential diagnosis of lyme arthritis and synovial hemangioma due to similar clinical and radiological signs and symptoms. A 15-year-old boy presented at the age of 9 with recurrent rather painless swelling of the right knee. Altogether four episodes lasting for 1-2 weeks each occurred over a period of 18 months before medical advice was sought. Physical examination revealed only a slightly limited range of motion. Living in an endemic area of borreliosis, he reported a tick bite 6 months prior to onset of his symptoms with erythema migrans and was treated for 10 days with amoxicillin. Serology revealed two positive unspecific bands in IgG immunoblot (p41 and 66) with slight positivity for ELISA. Ultrasound revealed synovial thickening and increased fluid. Despite the weak positive serology a diagnosis of lyme arthritis could not be excluded and intravenous antibiotic treatment with ceftriaxone was started. After two further relapses antiinflammatory therapy including intraarticular steroids were introduced with no long lasting effect. A chronical disease developed with alternate periods of swelling and almost complete remission. Ultrasound as well as MRI demonstrated ongoing signs of synovitis, therefore after further progression, a diagnostic arthroscopy was performed showing an inconspicuous knee joint. A second MRI showed focal suprapatellar enhancement and was followed by open arthrotomy revealing a histopathological proven synovial cavernous juxtaarticular hemangioma. To our knowledge, the differential diagnosis of lyme arthritis and synovial hemangioma has not yet been reported despite obvious clinical similarities. In conclusion, in children and adolescents synovial hemangioma has to be considered in differential diagnosis of recurrent knee swelling. Early diagnosis is important to prevent prolonged suffering from chronic joint swelling with probable joint damages, unnecessary treatment procedures and as well school and sports absenteeism.

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Section: Discussionmentioning

confidence: 99%

Mimicry of lyme arthritis by synovial hemangioma

et al. 2009

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Synovial Disorders of the Knee

Mlynarek

Ross²,

Fessell

et al. 2015

MRI-Arthroscopy Correlations

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Synovial hemangioma of the knee joint with cystic invasion of the femur: a case report and review of the literature

Holzapfel

Geitner

Diebold

et al. 2008

Arch Orthop Trauma Surg

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Synovial hemangioma is a rare benign intra-articular tumor. It may be a cause of pain and recurrent joint swelling in children and young adults. This report presents a 29-year-old patient with a synovial hemangioma in the left knee joint. Magnetic resonance imaging (MRI) showed the typical features of a soft tissue hemangioma and revealed a cystic invasion of the medial femur. The tumor was locally excised and a partial synovectomy was performed. The lesion of the femur was filled with autologous bone from the iliac crest. Histological examination confirmed the diagnosis of a synovial hemangioma. In a review of the recent literature we report the common features of a synovial hemangioma, with emphasis on its diagnosis and therapy.

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Synoviales Hämangiom als seltene Ursache eines Hämarthros

Cited by 5 publications

References 15 publications

Mimicry of lyme arthritis by synovial hemangioma

Mimicry of lyme arthritis by synovial hemangioma

Synovial Disorders of the Knee

Synovial hemangioma of the knee joint with cystic invasion of the femur: a case report and review of the literature

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