Synovial hemangioma

Case contributed by Utkarsh Kabra
Diagnosis almost certain

Presentation

Knee pain with restriction of movements. Past history of surgery/procedure (details not known).

Patient Data

Age: 20 years
Gender: Female
mri

Fairly well defined lesion measuring 19 x 25 x 45mm at medial aspect medial femoral condyle. It is causing smooth scalloping of adjacent femoral cortex (with no obvious marrow edema), mildly splaying medial patellofemoral ligament, abutting medial facet of patella and mildly extending into medial aspects of Hoffa’s fat pad. Possible minimal intra-articular extension is seen. Lesion appears hyperintense on T2 with multiple intralesional hypointense areas possibly representing flow voids. Corresponding complimentary Doppler shows multiple tiny cystic spaces within the lesion with vascularity within.

Small subchondral cyst, measuring 5mm is seen in posterior periarticular aspect of lateral tibial condyle.

Case Discussion

Findings are consistent with a synovial hemangioma.

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