Abstract
Pathological lesions in and around a joint can arise from underlying dermis, subcutis, deep muscle, bone or synovium. Clinical presentation can include joint pain, joint swelling, palpable masses and mechanical restriction. Whilst giant cell tumour of tendon sheath, pigmented villonodular synovitis, synovial chondromatosis, lipoma arborescens, juxta articular myxomas and inflammatory arthritis are the better-known conditions of the joint. Intra-articular nodular fasciitis, on the other hand, is less well recognized both clinically and radiologically. It is rarely seen in routine practice and is only described in case reports in the literature. Due to the non-specific clinical and radiological findings as well as the unfamiliarity with the entity, the diagnosis of intra-articular nodular fasciitis is usually clinched only after histological examination. We present a case of intra-articular nodular fasciitis arising in the knee joint which was not suspected clinically or radiologically. Intra-articular, nodular fasciitis, joint, knee, MRI.
Highlights
Nodular fasciitis is a well-known benign reactive proliferation which typically presents with a history of a rapidly growing single subcutaneous mass, usually in the upper limbs or trunk with men and women being affected
Based on the persistent knee effusion and MRI suggestion of haemosiderin deposits, the working diagnosis was changed to pigmented villonodular synovitis
Ten of the cases were part of a case series by Hornick and Fletcher in 2006 1. They highlighted the knee as the commonest joint to be affected by intra-articular nodular fasciitis
Summary
Introduction Nodular fasciitis is a well-known benign reactive proliferation which typically presents with a history of a rapidly growing single subcutaneous mass, usually in the upper limbs or trunk with men and women being affected. When present in infants and children, nodular fasciitis usually affects the head and neck region. We present a case of an intra-articular nodular fasciitis which followed a history of trauma.
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