Age / Sex : 27 / M

Chief complaint: right knee pain                         

Gouty arthritis of the knee

Discussion

Findings:

Even synovial thickening with effusion, indicating non specific synovitis.

At popliteal groove and intercondylar notch, intermediate to low SI intraarticular masses, possible finding of gouty tophi.

Differential Diagnosis: PVNS, rheumatoid arthritis.

Diagnosis:  gouty arthritis

Discussion:

Intraarticular mass formation, relatively uniform and thinner synovium were more frequent and more numerous in gouty arthritis. The characteristic feature of intraarticular masses were intermediate signal intensity on both T1 and T2WI with strong heterogenous enhancement. And proliferative synovium showed also intermediate SI on both T1 and T2 WIs with moderate enhancement. Theses intraarticular masses were commonly located on anterior joint recess, popliteal groove and the intercondylar fossa in gouty arthritis. Secondary lipoma arborescens was more frequen finding in gouty arthritis than rheumatoid arthritis of the knee

References:

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8.     Cimmino MA, Zampogna G, Parodi M et al. “MRI synovitis and bone lesions are common in acute gouty arthritis of the wrist even during the first attack.” Ann Rheum Dis 2011;70:2238_9.