Presentation
Chronic knee pain. No history of trauma.
Patient Data
Age: 35 years
Gender: Female
From the case:
Pigmented villonodular synovitis - ankle
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A small well-defined opacity with no calcification is noted within the anterior talocrural joint with cortical erosion of the talus. An irregular margin with loss of the normal fat density within the adipose triangle of the Kager is also noted.
From the case:
Pigmented villonodular synovitis - ankle
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The MRI sequences demonstrate:
- a well-defined intrasynovial soft tissue mass within the anterior recess of the talocrural joint of intermediate signal on T1WI, high signal on PD fat saturation with heterogeneous enhancement on postcontrast sequences. Areas of low signal intensity and “blooming” artifact are noted on the gradient echo sequence due to hemosiderin deposition. An adjacent cortical erosion of the talus is noted
- other small intrasynovial masses of similar signal intensity and enhancement with “blooming” artifact and joint effusion are noted within the posterior recess of the talocrural and talocalcaneal joints
Case Discussion
MRI features are most consistent with a pigmented villonodular synovitis (PVNS).
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