Synovial hemangiomas of wrist and ankle joint: A report of two rare cases

Synovial hemangioma is a rare, benign, vascular tumor of synovium leading to joint pain and swelling. The most common site is the knee joint, but rare cases involving other sites have also been reported. We report two rare cases of synovial hemangioma, one involving the ankle joint and other involving the wrist joint. Histopathology is the gold standard for diagnosis of these cases. Early treatment is warranted to prevent the risk of permanent joint damage.

The value of MRI in diagnosis of synovial hemangioma / 实用放射学杂志

Objective To evaluate the MRI findings of synovial hemangioma.Methods Twenty-three patients with synovial hemangioma were analyzed retrospectively,and MRI characteristics were summarized.Results Of the 23 patients,there were localized type in 6 and diffuse type in 17.Localized tumors located in the articular synovial tissue and didn't invade articular capsule and peripheral tissues.T hey had envelope,well-defined margin and regular shape.5 cases showed heterogeneous signal with iso-intense or hypo-intense on T1WI,hyper-intense and internal patchy or multiple pinstripe hypo-intense on T2WI and fat-suppression sequence.Diffuse tumors distributed inside and outside the articulation,and invaded the articular capsule or peripheral tissues.17 cases were heterogeneous signal with iso-intense or hypo-intense and internal patchy or sinuous hyper-intense on T1WI,hyper-intense and internal patchy,nodular and multiple pinstripe hypo-intense on T2WI and fat-suppression sequence.Thick flow void of the vessels were showed in 6 cases and phlebolithes were showed in 3 cases.15 cases underwent contrast-enhanced scan,and the tumors showed patchy,nodular or tortuous vascular heterogeneous enhancement with internal patchy,nodular or cord-like non-enhanced areas.Conclusion Fatty-fibrous tissues and flow void of the vessels in the tumor are valuable MRI features for diagnosis of the synovial hemangioma.

Recurred Multiple Intraarticular Synovial Hemangioma of the Knee: Case Report / 대한정형외과연구학회지

Synovial hemangioma is a rare benign intraarticular tumor. Synovial hemangioma of the knee joint has unspecific symptoms, which are pain, limitation of motion and hemarthrosis, often seen as an internal derangement of the knee. A 24-year-old woman presented with intermittent joint effusion and pain of the left knee joint and physical examination revealed slight atrophy of the quadriceps and tenderness around lateral joint line of knee. The patient was performed arthroscopic surgery due to synovial hemangioma about 17-years ago. Magnetic resonance imaging (MRI) showed the synovial hemangioma from Hoffa fat pad to anterior aspect of lateral meniscus, and thus surgical treatment was planned. Arthroscopic excision was performed and additional lesion was observed in lateral gutter, suprapatellar pouch of the knee. The biopsy confirmed the diagnosis of synovial hemangiomas. After 3 year, the patient was completely asymptomatic and showed no signs of recurrence.

A Case of Arthroscopic Excision of Synovial Hemangioma with Dual Coagulation Shaver

A 17-year-old male patient visited our hospital with a palpable mass on the lateral aspect of the knee joint of five years duration without any related trauma history. The patient felt tenderness around the mass and had limitations in doing flexion exercises. Magnetic resonance imaging of the knee suggested the possibility of synovial hemangioma, and thus surgical treatment was planned. A tumor within the knee joint was found by arthroscopy, and a resection was carried out by dual coagulation shaver. The biopsy confirmed the diagnosis of a synovial hemangiomas. The patient presented months later at the out-patient clinic with no evidence of recurrence.

A Case of Synovial Hemangioma of the Knee

We report an unusual case of a 17-years-old male with complaints of pain and swelling of the left knee for the last 3 years with limitation of movement. He presented with spontaneous hemarthrosis of the knee joint. Magnetic resonance imaging revealed an intra articular mass. Arthroscopic excision was performed and the histology was characteristic of synovial hemangioma. After 1 year, the patient was completely asymptomatic and showed no signs of recurrence.

Hemangioma sinovial de rodilla: reporte de un caso clínico / Synovial hemangioma of the knee: case report

Synovial hemangioma is a rare cause of recurrent and nonspecific complaints of the knee. Nontraumatic joint swelling combined with recurrent hemorrhagic joint effusions must be considered signs of a synovial hemangioma. MRI is the preoperative diagnostic tool of first choise in these cases. Early surgical treatment with excision of the tumor within margins of non-involved normal synovial prevents degenerative changes in the future. This article describes a case of a synovial hemangioma in a 15 year old patient and its resolution.

El hemangioma sinovial de rodilla es una causa rara de molestias inespecíficas y recurrentes de la rodilla relacionados con aumento de volumen localizado. Derrame no traumático combinado con hemartrosis recurrentes deben ser considerados como signos de un posible hemangioma sinovial. La resonancia magnética es el examen de elección previo a la cirugía para orientar el diagnóstico. Un tratamiento quirúrgico precoz, con resección de bordes sinoviales sanos permite prevenir cambios degenerativos a futuro. Este artículo describe el caso de un hemangioma sinovial de rodilla en un paciente de 15 años y su resolución.

Arthroscope-assisted diagnosis and treatment of intraarticular synovial hemangioma of knee / 第三军医大学学报

Objective To retrospectively review the diagnosis and treatment of intraarticular synovial hemangioma of the knee under arthroscope. Methods Six cases of intraarticular synovial hemangioma of the knee were included. The examination of X ray and MRI before surgery indicated intraarticular synovial hemangioma in 5 cases and pigmented villonodular synovitis in 1 case, then arthroscopic diagnosis and excision of the lesions were followed. Results The six cases were definitely diagnosed as intraarticular synovial hemangioma. Under arthroscope, the lesions exhibited as irregular dark blue or purple capillary clumps of different sizes. The postoperative follow-up of 10.7 months in average (range 4-23 months) shows good joint function for all the patients and no signs of recurrence at the last follow-up. Conclusion Intraarticular synovial hemangioma is rare with a high rate of misdiagnosis. Careful physical examination and MRI can help to make the diagnosis. Arthroscopic surgery is a choice of diagnosis and treatment for intraarticular synovial hemangioma of knee.

MRI Diagnosis of Synovial Hemangioma of the Knee(A Report of 7 Cases) / 实用放射学杂志

Objective To probe the diagnostic value of MRI in synovial hemangioma of the knee.Methods Seven patients(2 male,5 female,age ranged from 8 to 58 years with mean age 25.1 years) selected from 2025 cases with MRI examination of knee,which were proved to be intra-articular hemangiomas histologically or clinically.All of the patients had plain film before MRI examination.MR findings of synovial hemangioma of knee were analysed ultrasound.Results Four hemangiomas occurred in infrapatellar bursa,others 3 cases in both infrapatellar and suprapatellar bursa were involved.MR signal intensity of hemangiomas appeared three types:(1)nodular hypointensity on both T_1WI and T_2WI in 2 cases;(2)iso-hypointensity on T_1WI and hyper-hypointensity on T_2WI in 2 cases;(3)hypointensity mixed with isontensity on T_1WI and nodular of linear mixedintensity on T_2WI in 3 cases.The difference of synovial hemangioma of knee in histologic elements,the MR findings were different.Conclusion MRI features of synovial hemangioma are correlated with pathology histologic elements.