Synovial hemangioma

Case contributed by Domenico Nicoletti
Diagnosis probable

Presentation

Knee pain and swelling without trauma.

Patient Data

Age: 9 years
Gender: Male
x-ray

Soft tissue swelling with round calcifications (phleboliths). Bone is normal.

mri

A lesion that completely occupies Hoffa’s body and extends into over patellar synovial recess. The lesion has heterogeneous signal, hyperintense on T2 and assumes MDC defining elongated vessels with a serpiginous course and some calcifications. Small formations of adipose tissue in the vascular spaces are detectable. 

Case Discussion

Synovial hemangioma is a neoplastic vascular proliferation or the outcome of trauma. Angiography is useful for diagnosis and therapeutic embolization. The differential diagnosis is pigmented villonodular synovitis and lipoma arborescens.

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