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Intra-articular venous malformations of the knee: a diagnostic challenge
Intra-articular venous malformations of the knee: a diagnostic challenge
- Source :
- Pediatric Rheumatology Online Journal, Pediatric Rheumatology Online Journal, Vol 19, Iss 1, Pp 1-7 (2021)
- Publication Year :
- 2021
- Publisher :
- BioMed Central, 2021.
-
Abstract
- Background Intra-articular venous malformations (IAVM) are rare benign vascular anomalies that usually affect young patients and most common locate in the knee. The terminology of these lesions is still ill-defined, as they are often termed in the literature as synovial hemangiomas. Early diagnosis can be difficult, because they usually present with nonspecific clinical manifestations that are similar those of other rheumatic diseases, especially juvenile idiopathic arthritis (JIA). Case series We conducted a retrospective analysis of five pediatric patients admitted to our units for recurrent swelling of the knee, and compared their characteristics with those of literature reports. The average age at first symptom and time from onset to diagnosis was 3.9 years (range 18 months-7 years) and 3.5 years (range 1-7 years), respectively. In our patients, an initial misdiagnosis of JIA, bleeding disorder or traumatic arthropathy was made. On MRI imaging, the features of the lesion were similar in all patients, and were marked by isointense-to-hypointense signal in T1-weighted images, and hyperintense signal in T2-weighted images. When performed, arthrocentesis led to aspiration of bloody fluid. The diagnosis was confirmed with a biopsy and histopathologic assessment in all patients. Open surgery enabled complete excision of the mass and was followed by stable remission over time in all cases. Conclusions Our report highlights the challenges that may be posed by the detection of knee IAVM and the frequent long delay between onset of symptoms and diagnosis. The key elements for early recognition include careful assessment of patient history, demonstration of bloody fluid on arthrocentesis, and proper interpretation of MRI scanning.
- Subjects :
- Male
medicine.medical_specialty
Knee Joint
Vascular Malformations
medicine.medical_treatment
Arthritis
Case Report
Vascular malformation
Diseases of the musculoskeletal system
Pediatrics
RJ1-570
Diagnosis, Differential
Rheumatology
Internal medicine
Biopsy
medicine
Differential diagnosis
Intra-articular venous malformation
Synovial hemangioma
Immunology and Allergy
Humans
Medical history
Child
Retrospective Studies
Ultrasonography
medicine.diagnostic_test
business.industry
Arthrocentesis
Infant
medicine.disease
Magnetic Resonance Imaging
Bloody
RC925-935
Child, Preschool
Pediatrics, Perinatology and Child Health
Female
Radiology
Joint Diseases
business
Follow-Up Studies
Subjects
Details
- Language :
- English
- ISSN :
- 15460096
- Volume :
- 19
- Database :
- OpenAIRE
- Journal :
- Pediatric Rheumatology Online Journal
- Accession number :
- edsair.doi.dedup.....eec3aaa5edcbc51b267acaf7ff4bd5b9