Synovial Hemangioma: A Rare Case of Knee Joint Tumefaction in Children

Alaoui, N. Mrani; Lamalmi, Najat; Saouab, Rachida; Gourinda, H.; Dendane, M.A.

doi:10.1016/j.avsg.2012.08.019

Cited by 7 publications

(7 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The three reported patients with KSH near the superior pole of the patella had the rare phenomenon of bone erosion, which was localized in the patella in two cases, a previously undescribed location for KSH bone erosion, and in the supratrochlear cortical bone in one case. It is most frequent in tumors located in the medial compartment ( 2 , 3 , 6 , 39 ) or diffusely distributed ( 31 , 34 ).…”

Section: Discussionmentioning

confidence: 99%

“…Pain is typically in the anterior aspect of the knee but can be posterior ( 14 ) or diffuse. Swelling, tenderness, effusion ( 5 , 9 – 11 , 17 , 21 , 23 , 26 , 30 , 33 , 34 , 44 , 49 , 50 , 55 ) and haemarthrosis ( 5 , 9 , 11 , 12 , 18 , 22 , 30 , 31 , 37 , 39 , 41 , 46 , 50 , 54 , 55 , 57 , 59 ) are frequent and can be recurrent. Occasionally, a palpable soft tissue mass ( 3 , 4 , 10 , 44 , 46 , 55 , 61 ) can be noted.…”

Section: Discussionmentioning

confidence: 99%

“…Anterior masses are more evident in complete flexion of the knee ( 3 , 21 , 44 ) and can be compressible, refilling when pressure is released ( 21 ). Limitation of motion ( 3 , 5 , 8 – 10 , 12 , 17 , 25 , 28 , 33 , 37 , 38 , 46 , 61 ) and mild muscular atrophy ( 5 , 11 , 33 , 34 , 36 , 49 , 55 ) can be present. Joint locking is infrequent but has been described when synovial haemangioma is located in the intercondylar notch ( 22 , 47 ) or in the suprapatellar pouch ( 6 ).…”

Section: Discussionmentioning

confidence: 99%

“…MRI is useful for demonstrating extension into the periarticular tissues ( 7 ), for detecting bone erosion in our cases, for surgical planning, and for following recurrence. Intravenous administration of gadolinium for MRGd produces inhomogeneous enhancement of the synovial tumor image ( 9 , 14 , 27 , 34 , 38 , 46 , 59 ) and permits differentiation between cystic synovial hyperplasia ( 52 ) and liquid or intra-articular haemangioma ( 2 , 7 , 38 , 57 ). MRA and MDCTA have replaced arteriography, and while both are invasive and non-specific methods ( 20 , 50 ), they may be justified for planning surgery in diffuse or extended cases ( 3 , 32 , 46 ) and in cases where complete excision is not possible and where embolization might be considered ( 7 , 57 ).…”

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Location, Clinical Presentation, Diagnostic Algorithm and Open vs. Arthroscopic Surgery of Knee Synovial Haemangioma: A Report of Four Cases and a Literature Review

et al. 2021

View full text Add to dashboard Cite

Objective: The aim was to report 4 patients with intra-articular knee synovial haemangioma (KSH) and to perform a systematic review to describe the patient characteristics, patterns of tumor location, clinical presentation, usefulness of imaging examinations, pros and cons of arthroscopic vs. open resection, and follow-up in the literature.Design: From 1996 to 2016, four patients with KSH were retrospectively reviewed. A literature search was conducted in PubMed from 2000/01 to 2020/06 using the search terms “synovial haemangioma” and “knee.” Fifty full-text articles that included a total of 92 patients were included for further discussion.Results: Four adults (20–40 years) were diagnosed with KSH. Three lesions located in the suprapatellar pouch, two eroding the patella and one the supratrochlear bone, and one in the posterior compartment. Persistent anterior knee pain was the main complain. MRI revealed a benign tumor mass in all cases except one. Open excisional biopsy and regional synovectomy were performed in three patients, and by arthroscopy of the posterior compartment in the fourth. Histological type was arteriovenous in three cases and capillary in one. A pain-free knee without recurrence was achieve in all cases except one, which was successfully reoperated. Average follow-up time was 3.5 years. A literature review showed that KSH appears most frequently in children and teenagers (64.6%) and does not differ by gender. The suprapatellar and patella-femoral joint compartment was the most frequent location (47.9%). The bony tissue of the knee was rarely affected (13.5%). Pain, swelling and haemarthrosis were frequently reported (88.2, 66.7, and 47.1%). MRI was the most commonly used imaging test (98%). Treatment consisted of regional synovectomy by open surgery or arthroscopy in 66.7 and 15.6% of cases, respectively.Conclusions: KSH should be considered in the differential diagnosis of adult patients with chronic low-intensity knee pain. MRI is the most useful exam because it establishes the location, extent and benign characteristics of the tumor. Definitive diagnosis requires histological examination. We believe excisional biopsy and regional synovectomy by arthroscopy should be the treatments of choice for intra-articular tumors, but we recommend open surgery when the lesion extends to the tendons, muscle or bone.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Location, Clinical Presentation, Diagnostic Algorithm and Open vs. Arthroscopic Surgery of Knee Synovial Haemangioma: A Report of Four Cases and a Literature Review

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Plain radiographs are of limited value, as they are normal in at least half of the patients. On ultrasonography, the IAVM is seen as an iso- or hyperechogenic mass with a posterior reinforcement, accompanied with enhanced venous vascularization [ 27 ]. Abnormal venous drainage around the joint can also be detected [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

Intra-articular venous malformations of the knee: a diagnostic challenge

et al. 2021

View full text Add to dashboard Cite

Background Intra-articular venous malformations (IAVM) are rare benign vascular anomalies that usually affect young patients and most common locate in the knee. The terminology of these lesions is still ill-defined, as they are often termed in the literature as synovial hemangiomas. Early diagnosis can be difficult, because they usually present with nonspecific clinical manifestations that are similar those of other rheumatic diseases, especially juvenile idiopathic arthritis (JIA). Case series We conducted a retrospective analysis of five pediatric patients admitted to our units for recurrent swelling of the knee, and compared their characteristics with those of literature reports. The average age at first symptom and time from onset to diagnosis was 3.9 years (range 18 months-7 years) and 3.5 years (range 1-7 years), respectively. In our patients, an initial misdiagnosis of JIA, bleeding disorder or traumatic arthropathy was made. On MRI imaging, the features of the lesion were similar in all patients, and were marked by isointense-to-hypointense signal in T1-weighted images, and hyperintense signal in T2-weighted images. When performed, arthrocentesis led to aspiration of bloody fluid. The diagnosis was confirmed with a biopsy and histopathologic assessment in all patients. Open surgery enabled complete excision of the mass and was followed by stable remission over time in all cases. Conclusions Our report highlights the challenges that may be posed by the detection of knee IAVM and the frequent long delay between onset of symptoms and diagnosis. The key elements for early recognition include careful assessment of patient history, demonstration of bloody fluid on arthrocentesis, and proper interpretation of MRI scanning.

show abstract