Ankle joint hematoma masquerading as PVNS

Case contributed by Dr Chris O'Donnell


Fell and hurt ankle. Ongoing pain and swelling especially anteriorly.

Patient Data

Age: 55
Gender: Female

Ankle joint effusion with reactive synovitis (contrast enhancement in synovium) together with a mass in the anterior recess of the joint - heterogeneous signal intensity and subtle susceptibility artefact suggesting blood product.  Interpreted as PVNS but has no enhancement and central T1 hyperintensity indictaing methaemaglobin.


6 weeks later

Follow-up scan without surgery shows almost complete resolution with a small residual joint effison and minor residual "mass"

Case Discussion

Rather than a traumatic haemathrosis where the blood remains liquid and mixes with joint fluid, in this case the blood has clotted and formed a haemtoma acting as a "loose body" in the joint.
PlayAdd to Share

Case information

rID: 19663
Published: 2nd Oct 2012
Last edited: 14th Aug 2019
Inclusion in quiz mode: Included

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.