Presentation
Persistent knee pain, resistant to therapy.
Patient Data
There is diffuse irregular thickening and proliferation of the synovial lining of the right knee joint anterior and posterior recesses and suprapatellar bursae forming nodular and villous projections associated with moderate joint effusion.
These projections exhibit low signal intensity on T1 and intermediate signal intensity on T2 and PD fat suppression sequences.
The synovial membrane and nodular projections exhibit low signal intensity on T1/T2 and PD fat suppression sequences suggesting possible hemosiderine deposition.
No evidence of bony erosion is depicted.
Case Discussion
Tenosynovial giant cell tumors are fibrohistiocytic tumors arising from the synovium of joints. This particular example looks like a diffuse type and has been previously known under the term pigmented villonodular synovitis (PVNS). Although radiologically characteristic, the differential diagnoses may include siderotic synovitis, synovial osteochondromatosis, and rheumatoid arthritis.
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