1/12. Atraumatic hemarthrosis caused by a large mediopatellar plica.hemarthrosis of the knee has various etiologies and is classified into atraumatic or post-traumatic. Among atraumatic factors, hemarthrosis due to synovial plica is extremely rare. We report a case of atraumatic hemarthrosis caused by the mediopatellar plica. A 21-year-old male truck driver was referred to our hospital, because of swelling and pain of the right knee without history of trauma. Bloody synovial fluid was aspirated by arthrocentesis. However, his symptoms recurred and persisted. The range of motion was normal, but the patient complained of anteromedial knee pain during maximum flexion. Routine biochemical analyses were within normal limits. Plain radiographs were normal. magnetic resonance imaging (MRI) of the knee showed the hypertrophic mediopatellar plica and an irregular signal of the infrapatellar fat pad. arthroscopy revealed a voluminous mediopatellar plica trapped between the patella and the medial femoral condyle. It attached to the center of the infrapatellar fat pad, the so-called tongue. When the tourniquet was released, fresh bleeding was observed from the region between the mediopatellar plica and the tongue. Because that region was considered to be the cause of the hemarthrosis, the mediopatellar plica and the tongue were excised. A histologic examination of the tongue showed evidence of bleeding with nonspecific synovitis. After the procedure, the patient was asymptomatic and there were no clinical signs of recurrence.- - - - - - - - - - ranking = 1keywords = synovitis (Clic here for more details about this article) |
2/12. Successful arthroscopic treatment of pigmented villonodular synovitis of the knee in a patient with congenital deficiency of plasminogen activator inhibitor-1 and recurrent haemarthrosis.We report the arthroscopic treatment of pigmented villonodular synovitis (PVNS) in a 13-year-old Japanese boy with congenital partial deficiency of plasminogen activator inhibitor-1 (PAI-1). He was admitted to our hospital with recurrent haemarthrosis of his right knee. Characteristic abnormalities of fibrinolysis included shortened euglobulin lysis time, low PAI-1 activity and low PAI-1 antigen levels. In addition, levels of "active PAI" in the plasma, which is a measure of total PAI bound to exogenous plasminogen activator, were very low. These parameters remained low after venous occlusion. The diagnosis of PVNS was established by synovial membrane biopsy, and arthroscopic synovectomy was performed with adjuvant administration of intravenous tranexamic acid. Subsequent bleeding episodes have been well controlled by oral administration of tranexamic acid on demand.- - - - - - - - - - ranking = 5keywords = synovitis (Clic here for more details about this article) |
3/12. Intra-articular hemangioma of the knee.Intra-articular hemangioma of the knee is a rare cause of pain and spontaneous hemarthrosis, often seen as an internal derangement of the joint in children and young adults. The tumor is observed in two different forms: the synovial hemangioma or the arteriovenous malformation named also as hemangiohamartomas. They may cause hemorrhagic synovitis and arthropathy, probably as a result of recurrent episodes of intra-articular bleeding and mechanical irritation. Four cases of intra-articular hemangioma of the knee are presented in this study. Two of our cases were diagnosed as synovial hemangioma with the lesions localized inside the knee and the other 2 were intermediate type with the tumor extending to the muscle group and the skin. After magnetic resonance imaging and angiographic assessment, arthroscopic excision was performed in the localized type of the tumor. The other 2 cases received only diagnostic arthroscopy and biopsy followed by conservative treatment due to the extensive localization of the tumors and the serious chondral lesions. The decision of the treatment modality is very difficult in intra-articular hemangioma of the knee because, when combined with chondral degeneration, the incidence of local recurrence is high.- - - - - - - - - - ranking = 1keywords = synovitis (Clic here for more details about this article) |
4/12. An unusual cause of popliteal cyst.We describe a surgical treatment for popliteal cyst in a 41-year-old woman affected by diffuse pigmented villonodular synovitis (PVNS) of the knee with extra-articular spreading. The treatment consists of an arthroscopic synoviectomy followed immediately by an open removal of the cyst. At 28-month follow-up, the patient is asymptomatic and no evidence of recurrence of PVNS has been seen. We believe that this double surgical approach may reduce the probability of recurrence of PVNS.- - - - - - - - - - ranking = 1keywords = synovitis (Clic here for more details about this article) |
5/12. Recurrent hemarthrosis associated with gout.gout commonly occurs as an acute arthritis. In a 64-year-old man, gout was associated with a proliferative hemosiderin-laden synovitis. The association of recurrent atraumatic hemarthrosis seems not to have been reported in the literature on gout.- - - - - - - - - - ranking = 1keywords = synovitis (Clic here for more details about this article) |
6/12. Pigmented villonodular synovitis of the ankle occurring in a patient on anticoagulation therapy.A case report is presented of a 45-year-old woman with an 18-month history of pain and swelling in her right ankle. There was no history of trauma. Routine investigations failed to elicit a diagnosis. The patient had been on warfarin anticoagulation therapy for 12 years. The onset of symptoms coincided with a period of poor control of her anticoagulation therapy and her international normalized ratio was recorded at 5 or above on three occasions. A diagnosis of pigmented villonodular synovitis (PVNS) was made on arthroscopic examination of her ankle; this was confirmed histologically. The etiology of PVNS remains controversial. hemarthrosis has been suggested as an etiological factor. Although there are reports of PVNS in patients with hemophilia, there are no reports of PVNS occurring in patients on anticoagulation therapy. This case report supports a possible role for hemarthrosis in the etiology of PVNS.- - - - - - - - - - ranking = 5keywords = synovitis (Clic here for more details about this article) |
7/12. An unusual meniscal ganglion cyst that triggered recurrent hemarthrosis of the knee.A 58-year-old woman suffered spontaneous recurrent hemarthrosis of the knee. In the clinical course, pigmented villonodular synovitis was mostly suspected, but in arthroscopic surgery the lateral meniscus appeared to be upturned and stuck into the lateral pouch with the meniscal ganglion cyst. It was suggested that meniscal tear with meniscal ganglion cyst was related with recurrent hemarthrosis. Generally, both the meniscal ganglion cysts and spontaneous recurrent hemarthrosis are highly rare conditions. In this case, we speculated that a negligible power could induce the meniscal tear with recurrent hemarthrosis in the particular situation in which the meniscal ganglion cyst existed. In other words, the meniscal ganglion cyst might basically and physically relate with hemorrhagic condition. Arthroscopically, the meniscal ganglion cyst was removed together with the anterior segment of the lateral meniscus. Recurrent hemarthrosis was treated successfully by resection of the meniscus.- - - - - - - - - - ranking = 1keywords = synovitis (Clic here for more details about this article) |
8/12. Arthropathy of the ankle in hemophilia.Seventy-five patients who had hemophilia were followed clinically and roentgenographically to assess the prevalence of hemarthrosis and the prevalence and severity of arthropathy of the ankle. The mean age of the patients at the time of follow-up was twenty-two years and seven months. The patients were divided into four age-groups: less than ten years (eleven patients), ten to nineteen years (twenty-one patients), twenty to thirty years (twenty-four patients), and more than thirty years (nineteen patients). Intra-articular bleeding occurred more frequently in the joints of the lower extremities than in the joints of the upper extremities. During the second decade of life, hemarthroses occurred more often in the ankle than in the knee. A history of recurrent bleeding into the ankle joint, chronic synovitis, and overgrowth of the medial portion of the distal tibial epiphysis was associated with an early onset of arthropathy. In older patients, compression arthrodesis of the ankle joint was helpful in eliminating pain, recurrent bleeding, and equinus deformity.- - - - - - - - - - ranking = 1keywords = synovitis (Clic here for more details about this article) |
9/12. Nonhemophilic hemosiderotic synovitis of the shoulder. A case report.In a nonhemophilic 72-year-old man, a persistent degenerative hemarthrosis of the shoulder joint was associated with a complete tear of the rotator cuff. Extensive, rusty synovial pigmentation and hyperplasia (hemosiderotic synovitis) mimicking pigmented villonodular synovitis (PVS) were noted at surgery. Spontaneous hemarthrosis of the shoulder includes rapid onset of severe pain, limitation of movement, subsequent appearance of a bruise on the affected shoulder and arm, and radiological evidence of joint degeneration. Hemosiderotic synovitis results from chronic intraarticular bleeding. With the breakdown of trapped hemoglobin, iron-containing hemosiderin is stored in synovial tissue producing rusty discoloration and proliferative reaction. The classic cytoarchitecture of PVS has additional subsynovial nodular proliferation of mononuclear cells. hemarthrosis may produce significant structural alteration of joints. Its prompt recognition and the awareness of underlying causes should lead to earlier diagnosis, appropriate therapy, less joint destruction, and better outcomes.- - - - - - - - - - ranking = 7keywords = synovitis (Clic here for more details about this article) |
10/12. Sickled cells in synovial fluid: clue to unsuspected hemoglobinopathy.In this report, we have described three patients who had hemarthroses, with sickled red blood cells discovered by analysis of synovial fluid. On the basis of this observation, each patient was evaluated for the presence of abnormal hemoglobins, and each was found to have a hemoglobinopathy that was previously unsuspected. These patients differ from those in other reports in that two of the three had no associated arthritic condition that could readily explain synovitis or a condition that predisposed them to bleeding into a joint. Although the accumulated evidence suggests that heterozygous hemoglobinopathies do not produce arthritic syndromes, these reports again raise that question. We cannot conclude, however, that the hemarthroses were definitively caused by the underlying hematologic abnormality. Important when synovial fluid is mixed with blood, since other medical conditions can be diagnosed if abnormal findings are detected.- - - - - - - - - - ranking = 1keywords = synovitis (Clic here for more details about this article) |
| | Next -> |