Localized Nodular Synovitis of the Knee: MR Imaging Appearance and Clinical Correlates in 21 Patients
Guo-Shu Huang1,
Chian-Her Lee2,
Wing P. Chan3,4,
Chen-Yu Chen1,
Joseph S. Yu5 and
Donald Resnick6
1 Department of Radiology, Tri-Service General Hospital, National Defense
Medical Center, 325, Section 2, Cheng-Kung Rd., Neihu, Taipei 114, Taiwan,
Republic of China.
2 Department of Orthopaedic Surgery, Tri-Service General Hospital, National
Defense Medical Center, Neihu, Taipei 114, Taiwan, Republic of China.
3 Department of Radiology, School of Medicine, Taipei Medical University, 250
Wu-Hsing St., Taipei 110, Taiwan, Republic of China.
4 Department of Radiology, Taipei Medical University, Municipal Wan Fang
Hospital, 111 Hsing-Long Rd., Section 3, Taipei 116, Taiwan, Republic of
China.
5 Department of Radiology, Ohio State University Medical Center, 633 Means Hall,
1654 Upham Dr., Columbus, OH 43210.
6 Department of Radiology, Veterans Affairs Medical Center, 3350 La Jolla
Village Dr., San Diego, CA 92161.
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Fig. 1A. —23-year-old man with localized nodular synovitis involving
infrapatellar fat pad who presented with pain and locking of right knee. Axial
spin-echo T1-weighted MR image (TR/TE, 650/15) shows mass (arrow)
with intermediate signal intensity occupying anterior joint space of knee.
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Fig. 1B. —23-year-old man with localized nodular synovitis involving
infrapatellar fat pad who presented with pain and locking of right knee.
Sagittal spin-echo T2-weighted MR image (2000/90) shows heterogeneous signal
intensity in polylobulated lesion (arrow) that extends from
infrapatellar fat pad to anterior aspect of intercondylar notch. Note small
circular foci of low signal intensity and linear region of fluidlike high
signal intensity in lesion.
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Fig. 1C. —23-year-old man with localized nodular synovitis involving
infrapatellar fat pad who presented with pain and locking of right knee.
Arthroscopic image shows polylobulated mass (arrows) occupying
anterior joint space of knee. Note medial femoral condyle
(asterisk).
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Fig. 2A. —25-year-old man with localized nodular synovitis involving
infrapatellar fat pad who presented with pain and restriction to terminal
extension of right knee. Coronal spin-echo T1-weighted MR image (TR/TE,
600/15) shows mass (arrow) in infrapatellar fat pad. Note that
surface is smooth despite its size.
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Fig. 2B. —25-year-old man with localized nodular synovitis involving
infrapatellar fat pad who presented with pain and restriction to terminal
extension of right knee. Coronal fat-suppressed fast spin-echo T2-weighted MR
image (3600/55) shows heterogeneous high signal intensity in polylobulated
mass (arrow).
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Fig. 2C. —25-year-old man with localized nodular synovitis involving
infrapatellar fat pad who presented with pain and restriction to terminal
extension of right knee. Contrast-enhanced spin-echo T1-weighted sagittal MR
image (515/15) with fat suppression shows enhancement of lesion
(arrow) caused by capillary proliferation.
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Fig. 3A. —21-year-old-man with localized nodular synovitis involving
suprapatellar pouch who presented with right knee pain and palpable mass.
Axial spin-echo T1-weighted MR image (TR/TE, 600/20) shows ovoid mass
(arrow) with slightly hyperintense signal relative to skeletal muscle
in lateral aspect of suprapatellar pouch.
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Fig. 3B. —21-year-old-man with localized nodular synovitis involving
suprapatellar pouch who presented with right knee pain and palpable mass.
Axial spin-echo T2-weighted MR image (1800/90) shows long pedicle (black
arrow) attaching mass (white arrow) to adjacent synovium.
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Fig. 4A. —21-year-old man with localized nodular synovitis in posterior aspect
of intercondylar notch of knee who presented with pain and sensation of
fullness in right knee. Sagittal spin-echo proton density–weighted MR
image (TR/TE, 1800/20) shows ovoid mass (arrow) adjacent to posterior
margin of posterior cruciate ligament.
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Fig. 4B. —21-year-old man with localized nodular synovitis in posterior aspect
of intercondylar notch of knee who presented with pain and sensation of
fullness in right knee. Sagittal T2-weighted MR image (1800/90) shows relative
low signal intensity of mass. Note linear areas of high signal intensity
(arrow) in lesion corresponding to regions of necrosis.
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Copyright © 2003 by the American Roentgen Ray Society.
