Age / Sex : 51 / M

Tenosynovial giant cell tumor, diffuse type

Discussion

Findings:

Synovial proliferation in anterior aspect of glenoid (combined mild bone marrow edema in anterior glenoid), posterior aspect of humeral head, bicipital groove, and axillary pouch.

- show low signal intensity on T2-weighted images and blooming artifact on precontrast thrive scan.

Differential Diagnosis:

Synovial (osteo)chondromatosis

Discussion:

• 1) Clinical manifestation: characteristically mono-articular, slowly progressive painful swelling, limitation of motion

• 2) Imaging findings

X-ray : effusion, soft tissue swelling, extrinsic bone erosion, absence of calcification

CT : hyperdense synovial thickening

MRI : synovial-based diffuse, plaque-like proliferation

T1WI : low to intermediate SI

T2WI : low SI, shortening of T2 relaxation time by hemosiderin

Gradient echo : blooming, susceptibility artifact caused by hemosiderin

Treatment : total synovectomy, radiation therapy


References:

Knee Surg, Sports Traumatol, Arthrosc 1999;7:249–256

RadioGraphics 2008;28:1493–1518