Abstract
BackgroundClassifications of intra-articular masses are infectious granulomatous diseases, non-infectious synovial proliferative processes (synovial chondromatosis, lipoma arborescens, rheumatoid arthritis, pigmented villonodular synovitis [PVNS]), vascular malformations, deposition disorders, neoplastic, and miscellaneous conditions. The aim of this study is to correlate the results of MRI with arthroscopy in characterization of different varieties of intra-articular synovial masses and mass-like lesions. This observational prospective study was conducted between February 2018 and August 2019. We screened 1000 routine musculoskeletal MRI examination during this period, 32 of which showed intra-articular synovial masses/mass-like lesions. The selected 32 patients (20 males and 12 females) have a mean age of 49.20 ± 2.0 years; all presented with joint swelling, pain, or difficulty of movement according to the joint affected. All patients underwent arthroscopy for histopathological correlation.ResultsThe final diagnosis was synovial chondromatosis in 14 patients (43.8%), PVNS in ten patients (31.3%), and lipoma arborescens in five patients (15.6%). Synovial chondrosarcoma, synovial hematoma, and synovial ganglion cyst each in one patient (3.1%). The concordance of MRI to arthroscopy was 96.6% accuracy, 91.7% sensitivity, 99% specificity, 52.3% PPV, and 99.9% NPV.ConclusionGood correlation was observed between MRI and arthroscopy in diagnosis of intra-articular synovial masses/mass-like lesions.
Highlights
Classifications of intra-articular masses are infectious granulomatous diseases, non-infectious synovial proliferative processes, vascular malformations, deposition disorders, neoplastic, and miscellaneous conditions
magnetic resonance imaging (MRI) often done before arthroscopic procedures, and usually management planes are based upon MRI findings [5]
The aim of this study is to correlate the results of MRI with arthroscopy in characterization of different varieties of intra-articular synovial masses and mass like lesions
Summary
Classifications of intra-articular masses are infectious granulomatous diseases, non-infectious synovial proliferative processes (synovial chondromatosis, lipoma arborescens, rheumatoid arthritis, pigmented villonodular synovitis [PVNS]), vascular malformations, deposition disorders, neoplastic, and miscellaneous conditions. The aim of this study is to correlate the results of MRI with arthroscopy in characterization of different varieties of intra-articular synovial masses and mass-like lesions. Simple classification of intra-articular masses as infectious granulomatous diseases (tuberculous and coccidioidomycosis arthritis), noninfectious synovial proliferative processes (synovial chondromatosis, lipoma arborescens, rheumatoid arthritis, pigmented villonodular synovitis [PVNS]), vascular malformations (arteriovenous malformations, synovial hemangioma), deposition disorders (amyloid arthropathy, gout), neoplastic (synovial sarcoma, synovial chondrosarcoma, synovial metastases), and miscellaneous conditions (cyclops lesion following arthroscopic repair of anterior cruciate ligament of the knee) [2, 3]. Conventional radiography, joint high-frequency ultrasonography (US), and musculoskeletal magnetic resonance imaging (MRI) are used in the diagnosis of synovial lesions and in follow-up [4].
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