Synovial knee affected in multiple hemangiomatosis

Abstract

Synovial hemangioma is a vascular lesion of joint cavities. It is a rare cause of pain and spontaneous hemarthrosis in the paediatric age group. It is often seen as an internal derangement of the knee. We present the case of a 37-year-old woman with a history of recurrent effusions of this joint. The MRI showed a soft tissue mass affecting the Hoffa's fat pad and the synovial surrounding the patella. Other hemangiomas were detected in other sides of the body. Through arthroscopy, we eliminated all the pathological tissue of the knee. The patient remains asymptomatic after 1 year.

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

“…Our other three cases were local sessile intra-articular SH located near the superior pole of the patella, by far the most frequent location in the anterior compartment of the knee ( 5 – 8 , 19 , 21 , 24 , 27 – 29 , 38 , 40 , 42 , 44 , 50 , 53 – 57 ), followed by the infrapatellar fat pad ( 11 , 18 , 23 , 30 , 45 , 59 ), the posterior compartment, the medial compartment ( 2 – 4 , 25 , 35 , 39 , 42 , 54 , 61 ) and the intercondylar notch ( 22 , 43 , 46 , 47 , 54 ). 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.…”

“…There are a number of small case series ( 4 – 10 , 12 , 51 – 57 , 61 ), the largest describing 14 cases ( 8 ). Most reports describe single clinical cases ( 1 – 3 , 11 , 13 – 50 ), which highlights the rarity of this type of tumor.…”

“…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.…”

“…Extra-synovial and intra-synovial locations have been described for joint tumors ( 8 ), with intra-synovial locations being more likely to affect cartilage ( 8 ). It can be a part of an angiodysplastic lesion of the extremities (Klippel-Trénaunay syndrome) with diffuse ( 9 , 10 ) or localized ( 11 ) involvement of the joint.…”

“…Only eight localized cases have been reported in the posterior compartment [one intermediate ( 5 ), three juxta-articular ( 1 , 12 ) and four intra-articular ( 13 – 17 )], one of which was reported twice ( 14 , 15 ). Most reports are single case studies ( 1 – 3 , 11 , 13 – 50 ), while case series are less common ( 4 – 10 , 12 , 51 – 57 ).…”