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Pigmented villonodular synovitis - knee

Case contributed by Dr Ammar Haouimi

Presentation

Three months history of painful swelling of the right knee.

Patient Data

Age: 25 years
Gender: Female

The MRI sequences demonstrate a moderate joint effusion with thickening and proliferation of the synovium mainly of the medial/lateral aspect of the suprapatellar recess with enhancement on postcontrast sequences. Multiple confluent nodular masses of various sizes seen mainly in the posterior recess of the knee joint, of low to intermediate signal on T1, high signal on PD fat sat with “blooming artifact" on gradient-echo due to hemosiderin deposition. The postcontrast sequences show moderate and heterogeneous enhancement. No evidence of extrinsic marginal bone erosions seen. 

Case Discussion

 The patient's age, the clinical presentation, and the MRI features suggest probably a pigmented villonodular synovitis (PVNS).

On imaging, the differential diagnosis should include non-ossified synovial osteochondromatosis and siderotic synovitis.

 

 

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Case information

rID: 81193
Published: 24th Aug 2020
Last edited: 25th Aug 2020
Inclusion in quiz mode: Included
Institution: Aurès Medical Imaging Center - Batna Algeria

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