Synovial hemangioma of the knee joint in a 12-year-old boy: a case report.

Anosheh Vakil-Adli,Peter Ritschl,Josef Hochreiter,Shahin Zandieh,Monika Huber

doi:10.1186/1752-1947-4-105

Abstract

IntroductionSynovial hemangioma is a rare condition and is frequently misdiagnosed, leading to a diagnostic delay of many years.Case presentationWe present a case of an atypical synovial hemangioma in a 12-year-old Caucasian boy with a diagnostic delay of 3 years.ConclusionIt is important to know that synovial hemangioma mostly affects the knee joint, showing recurrent bloody effusions without a history of trauma. If there are no intermittent effusions, the diagnosis will be even more difficult. In cases of nonspecific symptoms and longstanding knee pain the diagnosis of a synovial hemangioma should also be considered in order to avoid diagnostic delay. Magnetic resonance imaging is the main diagnostic tool to evaluate patients with synovial hemangioma, showing characteristic lace-like or linear patterns.Angiography can identify feeder vessels and offers the possibility of embolisation in the same setting. Surgical excision, either done per arthroscopy or per arthrotomy, is recommended as soon as possible to avoid the risk of damage to the cartilage.

Highlights

Synovial hemangioma is a rare condition and is frequently misdiagnosed, leading to a diagnostic delay of many years.Case presentation: We present a case of an atypical synovial hemangioma in a 12-year-old Caucasian boy with a diagnostic delay of 3 years
Either done per arthroscopy or per arthrotomy, is recommended as soon as possible to avoid the risk of damage to the cartilage
We present the case of an atypical synovial hemangioma of the knee joint, having no single bloody effusion

Summary

Conclusion

Synovial hemangioma is a rare condition and mostly affects the knee joints. If there are no intermittent bloody effusions there may be a diagnostic delay of up to many years. For this reason a synovial hemangioma should be considered in cases with nonspecific presentations and longstanding knee pain. Angiography should be part of the diagnostic approach as it can identify feeder vessels and offers the possibility of embolisation in the same setting. If the synovial hemangioma is an intermediate type arthrotomy should be performed. Consent Written informed consent was obtained from the patient's parents for publication of this case report and accompanying images. Forrest J, Staple TW: Synovial hemangioma of the knee.

Introduction

Discussion

Findings

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