MR imaging findings for differentiating nonhemophilic hemosiderotic synovitis from diffuse-type tenosynovial giant cell tumor of the knee

• Published in: Japanese journal of radiology Vol. 39; no. 1; pp. 76 - 83
• Main Authors: Ando, Tomohiro, Kato, Hiroki, Kawaguchi, Masaya, Nagano, Akihito, Hyodo, Fuminori, Matsuo, Masayuki
• Format: Journal Article
• Language: English
• Published: Tokyo Springer Japan 01.01.2021; Springer Nature B.V
• Subjects: Cartilage; Cartilage (articular); Imaging; Knee; Magnetic resonance imaging; Medicine; Medicine & Public Health; Meniscus; Nuclear Medicine; Original Article; Radiology; Radiotherapy; Synovitis; Synovium; Thickness; Tumors; Hemosiderotic synovitis; Diffuse-type tenosynovial giant cell tumor; T2-weighted images; Lateral articular cartilage injury; Lateral meniscus tear
• ISSN: 1867-1071; 1867-108X; 1867-108X
• DOI: 10.1007/s11604-020-01034-z

Purpose To evaluate the differences in MR findings between nonhemophilic hemosiderotic synovitis (HS) and diffuse-type tenosynovial giant cell tumor (D-TGCT) of the knee. Methods This study included 13 patients with histopathologically confirmed intra-articular hemosiderin deposition of the knee (eight with nonhemophilic HS and five with D-TGCT) who underwent preoperative MR imaging including T2*-weighted images (T2*WI). We retrospectively reviewed the MR images and compared MR findings between the two pathologies. Results Lateral meniscus tear and lateral articular cartilage injury (88% vs. 20%, p  < 0.05) and distribution in the suprapatellar bursa of the maximum thickness of T2* hypointense synovium (75% vs. 0%, p  < 0.05) were significantly more frequent in nonhemophilic HS than in D-TGCT, respectively. Among patients who underwent contrast-enhanced imaging, all five patients with nonhemophilic HS showed minimal to mild enhancement of the thickened synovium with superficial linear enhancement, whereas all four patients with D-TGCT showed moderate to severe enhancement ( p  < 0.01). Conclusion As compared with D-TGCT, lateral meniscus tear, lateral articular cartilage injury, lesser degree of contrast enhancement of the thickened synovium, and distribution in the suprapatellar bursa of the maximum thickness of T2* hypointense synovium were characteristic features of nonhemophilic HS.