J Diii 2016 06 004

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DIII-804; No. of Pages 11 ARTICLE IN PRESS

Diagnostic and Interventional Imaging (2016) xxx, xxx—xxx
CONTINUING EDUCATION PROGRAM: FOCUS. . .
Imaging of tumors and tumor-like lesions

of the knee
A. Larbi a,∗, P. Viala a, C. Cyteval b, F. Snene a,
J. Greffier a, M. Faruch c, J.-P. Beregi a
a
EA 2415, Department of medical imaging, University Hospital of Nîmes,
4, rue du Professeur-Robert-Debré, 30029 Nîmes, France
b
Department of osteoarticular radiology, University Hospital Lapeyronie,
371, avenue du Doyen-Gaston-Giraud, 34295 Montpellier cedex 5, France
c
Radiology and medical imaging, University Hospital of Toulouse, Hôpital Pierre-Paul-Riquet,
place du Docteur-Baylac, TSA 40031, 31059 Toulouse cedex 9, France
KEYWORDS Abstract Tumors and tumor-like lesions of the knee are common conditions. Because the
Knee; synovial membrane covers a large part of the knee, tumors and tumor-like lesions of the knee
MRI; are mostly synovial. Magnetic resonance imaging (MRI) plays a major role in the assessment and
Tumor; characterization of these lesions. However, the diagnostic approach of these lesions must be
Tumor-like lesion; performed systematically. First, the lesion must be precisely located, and then the anatomical
Synovium structure involved must be determined. Finally, clinical background that includes the age of
the patient, frequency of the disease and, if any, associated signs as well as MRI characteristics
must be analyzed. In this review, we describe the anatomy of the knee and its compartments
and provide a description of the main tumors and tumor-like lesions of the knee. We present
a diagnostic approach based on the location within the knee of the lesions and the anatomical
structures involved.
© 2016 Editions françaises de radiologie. Published by Elsevier Masson SAS. All rights reserved.
Tumors and tumor-like lesions of the knee are frequent. Because the synovial membrane
covers a large part of the knee, the tumors and tumor-like lesions of the knee are mostly
synovial. However, synovial tumors are rare and account for only a small part of the soft
tissue tumors, which are also rare. Indeed, soft tissue sarcomas represent only 1% of all
malignant tumors [1]. Tumors and tumor-like lesions are generally benign and arise from
inflammatory or degenerative articular disease.
∗ Corresponding author.
E-mail address: ahmed.larbi@chu-nimes.fr (A. Larbi).
http://dx.doi.org/10.1016/j.diii.2016.06.004
2211-5684/© 2016 Editions françaises de radiologie. Published by Elsevier Masson SAS. All rights reserved.
Please cite this article in press as: Larbi A, et al. Imaging of tumors and tumor-like lesions of the knee. Diagnostic and
Interventional Imaging (2016), http://dx.doi.org/10.1016/j.diii.2016.06.004
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2 A. Larbi et al.
Magnetic resonance imaging (MRI) plays a major role in supra- and infrapatellar (delimited by the patella) compart-
the assessment and characterization of tumors and tumor- ments (Fig. 2). Tumors and tumor-like lesions may be intra-
like lesions of the knee. The diagnosis must be approached or extra capsular. The knee joint, enclosed by the articu-
systematically. First, the lesion must be located in the knee. lar capsule, is also divided into an intra- and extrasynovial
Then, the anatomical structure involved must be defined. compartment (Fig. 3).
Finally, clinical and epidemiological parameters (age of the
patient, frequency, associated signs) and imaging (ultra- On which anatomic structure is the lesion
sound and MRI) must be analyzed to accurately establish the located?
diagnosis.
In this review, we describe the anatomy of the knee and The anterior compartment consists of fatty structures: infra-
its compartments and provide a description of the main and suprapatellar fat pad, prefemoral fat pad. The synovium
tumors and tumor-like lesions of the knee. We present a lines the deep layer of the articular capsule, the bone sur-
diagnostic approach based on the location within the knee faces not covered by cartilage as well as the intra-articular
of the lesions and the anatomical structures involved. ligaments and tendons. The synovium occupies thus a large
area of the knee.
Tumor-like lesions may arise in the meniscal-ligament
Anatomy of the knee structure. They include arthrofibrosis or ‘‘cyclops lesions’’,
a complication after rupture of the anterior cruciate lig-
The knee is a joint that has three compartments: the medial ament (ACL), meniscal cysts. Extra-articular lesions are
femoro-tibial joint, the lateral femoro-tibial joint and the located in muscles, fat and skin (Fig. 4).
patellofemoral joint. Like all joints, the knee is enclosed
by a fibrous and synovial capsule. The articular cavity is
limited anteriorly by the extensor system (quadricipital ten-
don, patella and patellar ligament), laterally by the lateral
Clinical manifestations
and medial ligaments and posteriorly by the capsule, condy- Because the synovial membrane covers a large part of the
lar shells and gastrocnemius (Fig. 1). knee, most tumors and tumor-like lesions are synovial in ori-
gin, even if they are rare. MRI is the ideal method to provide
In which compartment is the tumor located? information on these lesions, because it shows the synovial
membrane directly and can help characterize lesions based
The knee may be divided into three compartments: ante-
on their components such as fat, cartilage, and hemosiderin.
rior, posterior (delimited by the femoro-tibial axis), and
Figure 1. Anatomy of the knee joint, limited anteriorly by the

extensor system (blue arrows), laterally by the lateral and medial Figure 2. The different compartments of the knee: anterior and
ligaments and posteriorly by the capsule (green line), condylar posterior (delimited by the femoro-tibial axis) and supra- and infra-
shells and gastrocnemius. patellar (delimited by the patella) (green lines).
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Imaging of tumors and tumor-like lesions of the knee 3
Synovial hemangioma
Synovial hemangiomas of the knee are rare tumor-like
lesions that affect young patients in 60% of the cases [2—4].
Hemangiomas can be capillary, cavernous, mixed or venous.
They can be focal or more frequently diffuse (Fig. 5). In
most cases, they cause symptoms such as pain, limping and
joint swelling due to hemarthroses. MRI is the best imaging
modality to provide information on the extent of the lesion.
Tumor-like lesions may display ill-defined borders and infil-
trate neighboring structures without causing a mass effect.
On T1-weighted MR images, synovial hemangioma appears
hypo- or isointense to muscles. Large venous hemangiomas
may cause high signal intensity on T1-weighted sequences
caused by slow blood flow.
On T2- or fat-suppressed T2-weighted MR images heman-
giomas show hyperintense areas. Large lesions may show
heterogeneous enhancement after intravenous administra-
tion of a gadolinium chelate. Fine septa and a serpentine
appearance strongly support the diagnosis. In the cavernous
form, the presence of internal fluids is even more charac-
teristic.
These hemangiomas are very pigmented due to
hemosiderin caused by the resorption of bloody effusions
or hemorrhagic suffusions. The main differential diagnoses
are villonodular synovitis, synovial sarcoma and hemophilic
Figure 3. Anatomical delineation of the joint capsule: intra- arthropathy.
(green circle) or extracapsular (stars) and intrasynovial or extrasyn-
ovial (red line).
Synovial chondromatosis
Synovial chondromatosis is characterized by synovial meta-
plastic alteration causing small cartilaginous nodules at
the internal part of the synovial membrane. The nodules
become pedunculated and detach to become intrasynovial
loose bodies. The loose bodies vary in number, volume and
structure. Some patients present one single large loose
body, while others present multiple small ones. Some are
purely cartilaginous while others ossify. Symptoms include
mechanical-type pains, joint swelling and a feeling of knee
locking [5].
Most cases of synovial chondromatosis are primary, but
other cases may develop following arthrosis (Fig. 6) or multi-
ple epiphyseal dysplasia. It should be noted that exceptional
cases of synovial chondrosarcomas secondary to primary
chondromatosis have been reported [5].
It is difficult to diagnose primary synovial chondromatosis
with MRI because cartilage and synovial fluid show similar
signal intensity. Dynamic T1-weighted MR sequences may be
useful to reach the diagnosis because the synovial membrane
enhances after intravenous administration of a gadolinium
chelate whereas chondroma shows no enhancement.
Lipoma arborescens
Lipoma arborescens is a tumor-like lesion characterized
by fatty deposits under the synovial membrane, associ-
ated to multiple hypertrophied synovial fronds or villi [6,7].
Although all joints may be affected, this lesion is usu-
Figure 4. Anatomical structures of the knee joint from which the ally found in the suprapatellar recess. Lipoma arborescens
lesion arises. results from articular pathology causing chronic inflamma-
tion of the synovium.
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4 A. Larbi et al.
Figure 5. Forty-three-year-old woman with pain in the anterior compartment associated to repeated joint effusion due to synovial
hemangioma; a: T1-weighted MR image in the sagittal plane shows a lesion in the anterior infrapatellar compartment in the Hoffa’s fat
pad (arrow); b: T1-weighted MR image in the sagittal plane and T1-weighted MR image after intravenous administration of a gadolinium
chelate and fat-suppression, in the transverse plane, show a focal, hypointense lesion on T1-weighted images with homogeneous marked
enhancement (arrow); c: 8-year-old child with swelling associated to repeated effusion. T1-weighted MR image in the sagittal plane and
T1-weighted MR image after intravenous administration of a gadolinium chelate and fat-suppression, in the transverse plane show a diffuse
synovial hemangioma.
Figure 6. Seventy-two-year-old man with mechanical pain associated to posterior swelling caused by a large popliteal cyst filled with
secondary chondromatous nodules; a: lateral X-ray shows multiple chondromatous nodules located in the posterior compartment; b: arthro-
CT of the knee in sagittal plane shows that chondromatous nodules are located in a popliteal cyst (intracapsular and intrasynovial location);
c: antero-posterior X-ray of the knee shows severe medial tibio-femoral osteoarthritis.
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This condition produces clusters of synovial villi show- hemarthrosis and disabling mechanical pains (Fig. 9). Aspi-
ing a fat signal intensity identical to that of subcutaneous rated synovial fluid is typically serosanguinous.
fat (Fig. 7). Joint effusion is frequently associated. Ultra- Standard radiographs are generally normal or may show
sound shows the effusion, as well as the villous character an enlarged suprapatellar recess in case of hemarthrosis. In
of the mass. MRI can confirm the diagnosis by evidencing a its diffuse form, and especially in tight joints such as the hip,
hypersignal on T1- and T2-weighted images and hypertrophic bone erosion in the insertion areas of synovial membrane is
synovial villi. generally present, with sclerotic margins. This latter fea-
ture indicates a slow-growing condition [2]. These erosions
are less frequent in the knee (26%) than in the hip (93%) or
Villonodular synovitis shoulders (75%), probably because the articular capacity of
the knee is much greater [8].
Villonodular synovitis is a proliferative disorder of the syno- MRI is the best modality to diagnose and assess the extent
vial membrane characterized by fibrous stroma, deposits of of the diffuse form of villonodular synovitis. On T1- and T2-
hemosiderin, infiltration by histiocytes and giant cells. His- weighted MR sequences hypointensity indicates the fibrous
tologically it resembles a giant cell tumor of the tendon character of the lesion. The main sign is a magnetic suscepti-
sheath. bility artifact or ‘‘blooming artifact’’ causing an increase in
Villonodular synovitis comes in two forms: localized and signal intensity on gradient echo T2-weighted MR images.
diffuse. The most frequently affected joint is the knee (80%) This artifact corresponds to hemosiderin deposits. After
[8]. In the localized form the nodule is generally located intravenous administration of a gadolinium chelate, synovi-
in Hoffa’s fat pad or in the suprapatellar recess (Fig. 8). tis as well as synovial masses are visible. Fluid sequences
A feeling of joint locking may be the revealing symptom. (STIR or fat-suppressed T2-weighed) are useful to evidence
In its diffuse form, symptoms are joint swelling caused by joint effusion and bone edema in case of marginal erosions
Figure 7. Seventy-six-year-old man with repeated effusion caused by degenerative arthropathy and lipoma arborescens; a: T1-weighted
MR image in the sagittal plane shows the swelling in the anterior and suprapatellar compartment (star); b: the lipoma arborescens is located
in intracapsular and intrasynovial compartments; c: T1-weighted MR image before and after intravenous administration of a gadolinium
chelate and fat-suppressed, in the transverse plane show hypertrophic synovial fronds with fat signal (hyperintensity on T1-weighted images)
(arrow); associated with synovitis (marked enhancement on T1-weighted images after intravenous administration of a gadolinium chelate).
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6 A. Larbi et al.
Figure 8. Thirty-two-year-old woman with pain in the anterior compartment associated with repeated effusion caused by focal pigmented
villonodular synovitis; a: T1-weighted MR image in the sagittal plane shows a nodule in the anterior and infrapatellar compartment (arrow);
b: this nodule is located in the Hoffa’s fat pad (arrow); c: T2-weighted gradient-echo image in the sagittal plane shows the ‘‘blooming
artifact’’. Note the increased signal corresponding to deposits of hemosiderin (arrow).
the tibia during extension. Its pathophysiology is not well

known, although several mechanisms have been shown to
be involved: acute trauma, micro trauma, over-solicitation
(repeated hyperextension and rotation). These mechanisms
cause hypertrophy of the fat and start a vicious circle of
bleeding, acute inflammation and necrosis (Fig. 10), fibrosis,
even ossification when chronic (Fig. 11) [11].
Hoffa’s disease affects mostly young women. Generally,
symptoms consist of anterior knee pain during climbing
and descending stairs (patellofemoral syndrome). High-risk
sports are jump sports such as basketball, volleyball and
high jumping. Ligamentous laxity causing knee hyperexten-
sion may also cause inflammation of Hoffa’s pad. Clinical
signs include: reduced range of articular motion, crepitus,
moderate joint effusion and soft tissue swelling around the
ligament at the patellar joint.
Figure 9. Forty-two-year-old woman with chronic effusion. T2-
The differential diagnoses include patellar lateral
and gradient echo T2-weighted MR images in the sagittal plane
femoral friction syndrome (Fig. 12) [12], impingement of
show diffuse pigmented villonodular synovitis (arrows). Note the
increased signal. the infrapatellar plica and arthrofibrosis or ‘‘cyclops lesion’’
(Fig. 13). They are not always easy to differentiate because
of some degrees of between these three entities [13—15].
[9]. The main differential diagnoses are localized synovial The most suggestive MRI finding is the presence of marked
hemangioma (Fig. 5), hemophilic arthropathy, synovial sar- edema of the infrapatellar fat pad associated with a fibrous
coma and chronic tophaceous gout. area, which may contain deposits of hemosiderin and calci-
Recurrence is more frequent in the diffuse form (50%) fications (Fig. 10).
than in the tumoral form where the mass is easier to remove
surgically [10]. Cysts
Hoffa disease and its variants Popliteal cysts are the most frequent cysts in the knee. They
are synovial cysts that arise between the medial head of
Hoffa’s disease is an inflammatory condition caused by the gastrocnemius muscle and the semimembranosus ten-
impingement of Hoffa fat pad between the femur and don forming cavities of variable volume bordered by a thin
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Figure 10. Thirty-four-year-old man with patellofemoral syndrome caused by Hoffa’s disease; a: T1-weighted MR image in the sagittal
plane shows a lesion in the anterior and infrapatellar compartment (arrow); b: T1- and proton-density fat suppressed-weighted MR image
in the sagittal plane show infiltration of Hoffa’s fat pad (arrows) caused by acute Hoffa’s disease.
Figure 13. Thirty-five-year-old man with pain and a feeling of

Figure 11. Forty-two-year-old man with pain in the anterior com- knee locking. History of a sprained knee. T1- and T2-weighted MR
partment associated with swelling. T2-weighted MR image and CT image in the sagittal plane show hypointense area in the ante-
arthrography in the sagittal plane show a chondromatous nodule in rior and infrapatellar compartment caused by arthrofibrosis (Cyclop
Hoffa’s fat pad caused by chronic Hoffa’s disease (arrows). lesion) (arrows).
fibrous wall. The synovial lining may be altered and replaced classic example. They are cavities that develop in the medial
by fibrinous deposits. Discrete inflammatory reactions or part of the meniscus or in one of its horns and may reach
hyperplasia of the lining may also occur. 2 cm (Fig. 14). Meniscal cysts are filled with mucoid fluid that
In the knee, cyst-like degenerations may occur resulting is hypointense on T1-weighted MR images and hyperintense
from changes in the conjunctive matrix of some articular on T2-weighted images. After intravenous administration of
structures. Degenerative cyst-like lesions in meniscus are a
Figure 14. Fifty-two-year-old man with pain in the posterior

Figure 12. Thirty-two-year-old woman with pain in the antero- and medial compartment. PDFS- and T1-weighted MR image after
lateral compartment. PDFS-weighted MR image in the sagittal and intravenous administration of a gadolinium chelate, in the trans-
transverse planes show patellar lateral femoral friction syndrome: verse plane, show a mucoid medial parameniscal cyst: hypersignal
infiltration in Hoffa’s fat pad in its superolateral part associated intensity on fluid sequences with thin wall enhancement after intra-
with a patella alta (arrows). venous administration of a gadolinium chelate (arrow).
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8 A. Larbi et al.
a gadolinium chelate, a thin and homogeneous enhance- found in unexpected places, seemingly without synovial tis-
ment of the wall is observed. MRI is useful to differentiate sue such as the abdominal wall or the cervical region. Their
between popliteal cysts and other masses that develop in development is usually extra-articular (Fig. 16). Indeed,
the posterior part of the knee such as masses of vascular intra-articular lesions are observed in only 10% of the cases.
origin, varicose popliteal veins or popliteal artery aneurysm The development of this tumor looks more like the develop-
(Fig. 15) [16]. ment of a soft tissue tumor than that of an actual articular
tumor. They are evidenced by intratumoral calcifications
Synovial sarcoma or ossifications (30% of the cases) [17]. The prognosis of
synovial sarcoma is poor. The patient generally feels a slow-
Synovial sarcomas are malignant tumors observed generally growing soft tissue palpable mass. Recurrence occurs almost
in adolescents and young adults. Sixty percent of synovial always and survival at 5 years varies from 25 to 50% depend-
sarcomas are localized in lower limbs but they may also be ing on the series.
Figure 15. Sixty-nine-year-old man with swelling in the posterior compartment in the popliteal artery. T1-weighted MR image in the
sagittal plane shows a spontaneous heterogeneous hypersignal caused by parietal thrombus. CT angiography of the lower limbs confirms
right popliteal artery aneurysm (arrow).
Figure 16. Twenty-nine-year-old man with synovial sarcoma causing swelling in the anterior compartment that progresses slowly; a: T1-
weighted MR image in the sagittal plane shows a tumor in the anterior and supra- and infrapatellar compartment (arrows); b: the tumor is
located in the intracapsular and extrasynovial compartment (Hoffa’s fat pad) and extends outside the capsule in the prepatellar soft tissues;
c: T1-weighted MR image after intravenous administration of a gadolinium chelate, in the sagittal plane, shows an intense vascularization
(arrow).
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On MRI, the mass is hypointense on T1-weighted images A. Infrapatellar compartment.

and hyperintense on T2-weighted images. It usually has B. Posterior compartment.
multilobulated and well-defined borders with sometimes C. Anterior compartment.
internal septa. Foci of hemorrhagic necrosis have been D. Suprapatellar compartment.
observed in about 40% of the cases [18]. 2) What is the actual location of this lesion?
A. Intracapsular.
B. Extrasynovial.
Conclusion C. Intrasynovial.
D. Extracapsular.
In the presence of tumors or pseudotumors of the knee, 3) What is your diagnosis?
it is important to approach them systematically and first A. Pigmented villonodular synovitis.
determine their location in a compartment, establish the B. Primary synovial chondromatosis.
anatomical structure it originates from, and then review the C. Synovial sarcoma.
clinical presentation and MRI features. D. Suprapatellar plica.
Take-home messages
• Tumors, and tumor-like lesions of the knee, are
relatively frequent. Answers
• The diagnosis must be approached systematically:
Answer 1: C and D (Fig. 17b). T1-weighted MR image in
what compartment is affected? What anatomical
the sagittal plane shows isointense subquadricipital swelling
structure is involved? What are the characteristics
(anterior and suprapatellar compartment) (arrow).
of the lesion?
• Frequency and epidemiological factors must be Answer 2: A and C (Fig. 18). Note the swelling attached
to the synovial membrane, and its subsequent intracapsular
taken into account to reach the diagnosis.
and intrasynovial location.
Answer 3: D (Fig. 19). It was a complete suprapatellar
plica corresponding to a complete synovial recess separat-
ing the suprapatellar recess from the remaining joint. Post
enhanced T1-weighted MR image in sagittal and transverse
Clinical case planes shows the synovial enhancement of this plica. Note
the global enhancement of the synovial membrane caused by
A 15-year-old boy presented with pain in the right anterior synovitis and the absence of tumoral enhancement (arrows).
knee associated with repeated swelling. MRI was performed Arthrography shows the complete plica, with the supra-
(Fig. 17a). patellar recess isolated form the remaining joint (Fig. 20).
Arthroscopy (Fig. 21) evidences the complete plica
Questions (thin synovial membrane) and made treatment possible:
perforation to allow communication between supra- and
1) In which compartment is the lesion located? infrapatellar spaces.
Figure 17. Sagittal T1-weighted sequence (a). Location of the swelling (b).
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10 A. Larbi et al.
Figure 18. This figure shows the swelling attached to the synovial
membrane.
Figure 20. Arthrography shows opacification of the suprapatellar

recess.
Figure 19. Fat-suppressed T1-weighted images in the sagittal

and transverse plane obtained after intravenous administration of
a gadolinium chelate.
Figure 21. Arthroscopic view.
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Acknowledgements [8] Dorwart RH, Genant HK, Johnston WH, Morris JM. Pig-
mented villonodular synovitis of synovial joints: clinical,
We are thankful to Dr. Y. Thouvenin, CHU Lapeyronie, pathologic, and radiologic features. AJR Am J Roentgenol
1984;143:877—85.
Montpellier for providing the clinical case.
[9] Hughes TH, Sartoris DJ, Schweitzer ME, Resnick DL. Pig-
mented villonodular synovitis: MRI characteristics. Skeletal
Radiol 1995;24:7—12.
Disclosure of interest [10] Mancini GB, Lazzeri S, Bruno G, Pucci G. Localized pigmented
villonodular synovitis of the knee. Arthroscopy 1998;14:
The authors declare that they have no competing interest. 532—6.
[11] Larbi A, Cyteval C, Hamoui M, Dallaudiere B, Zarqane H, Viala P,
et al. Hoffa’s disease: a report on 5 cases. Diagn Interv Imaging
References 2014;95:1079—84.
[12] Barbier-Brion B, Lerais JM, Aubry S, Lepage D, Vidal
[1] Collin C, Hadju SI, Godbold J, Shiu MH, Hilaris BI, Brennan MF. C, Delabrousse E, et al. Magnetic resonance imaging in
Localized, operable soft tissue sarcoma of the lower extremity. patellar lateral femoral friction syndrome (PLFFS): prospec-
Arch Surg 1986;121:1425—33. tive case-control study. Diagn Interv Imaging 2012;93:
[2] Cotten A, Flipo RM, Herbaux B, Gougeon F, Lecomte-Houcke M, e171—82.
Chastanet P. Synovial haemangioma of the knee: a frequently [13] Cothran RL, McGuire PM, Helms CA, Major NM, Attarian DE.
misdiagnosed lesion. Skeletal Radiol 1995;24:257—61. MR imaging of infrapatellar plica injury. AJR Am J Roentgenol
[3] Greenspan A, Azouz EM, Matthews J, Décarie JC. Synovial 2003;180:1443—7.
hemangioma: imaging features in eight histologically proven [14] Johnson DP, Eastwood DM, Witherow PJ. Symptomatic syno-
cases, review of the literature, and differential diagnosis. vial plicae of the knee. J Bone Joint Surg Am 1993;75:
Skeletal Radiol 1995;24:583—90. 1485—96.
[4] Llauger J, Monill JM, Palmer J, Clotet M. Synovial heman- [15] Saddik D, McNally EG, Richardson M. MRI of Hoffa’s fat pad.
gioma of the knee: MRI findings in two cases. Skeletal Radiol Skeletal Radiol 2004;33:433—44.
1995;24:579—81. [16] Butler MG, Fuchigami KD, Chako A. MRI of posterior knee
[5] Hermann G, Abdelwahab IF, Klein M, Kenan S, Lewis M. Synovial masses. Skeletal Radiol 1996;25:309—17.
chondromatosis. Skeletal Radiol 1995;24:298—300. [17] Sánchez Reyes JM, Alcaraz Mexia M, Quiñones Tapia D, Aram-
[6] Haasbeek JF, Alvillar RE. Childhood lipoma arborescens buru JA. Extensively calcified synovial sarcoma. Skeletal Radio
presenting as bilateral suprapatellar masses. J Rheumatol 1997;26:671—3.
1999;26:683—6. [18] Blacksin MF, Siegel JR, Benevenia J, Aisner SC. Synovial
[7] Hallel T, Lew S, Bansal M. Villous lipomatous proliferation of the sarcoma: frequency of nonaggressive MR characteristics. J
synovial membrane (lipoma arborescens). J Bone Joint Surg Am Comput Assist Tomogr 1997;21:785—9.
1988;70:264—70.

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DIII-804; No. of Pages 11 ARTICLE IN PRESS

CONTINUING EDUCATION PROGRAM: FOCUS. . .

Imaging of tumors and tumor-like lesions

Figure 1. Anatomy of the knee joint, limited anteriorly by the

the tibia during extension. Its pathophysiology is not well

Figure 13. Thirty-ﬁve-year-old man with pain and a feeling of

Figure 14. Fifty-two-year-old man with pain in the posterior

On MRI, the mass is hypointense on T1-weighted images A. Infrapatellar compartment.

Figure 20. Arthrography shows opaciﬁcation of the suprapatellar

Figure 19. Fat-suppressed T1-weighted images in the sagittal

Figure 21. Arthroscopic view.

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