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Case of the Month – August 2019

By Dr Solokara Karunarathne

History:

Ongoing right knee pain and sudden swelling in 52 year old male.

 

Findings:

MRI KNEE demonstrates a lobulated mass in Hoffas fat pad inferior to the patella. It is high signal intensity on PDFS scans with thin low signal septae, intermediate signal intensity on PD images and shows intense enhancement following gadolinium. No blooming on T2* images.

 

Diagnosis:

Synovial haemangioma. It has been operated in 2006 but the patient has recurrent knee swelling possibly due to a heamarthrosis.

 

Discussion:

These are rare tumours which present with recurrent haemarthrosis and knee pain. Treatment includes surgical excision. Angiography can be used to identify feeder vessels for embolisation consideration.

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