Synovial hemangioma

Last revised by Joshua Yap on 13 Oct 2022

Synovial hemangiomas are rare benign vascular malformations that occur in relation to the joint. They are sometimes considered a subtype of soft tissue hemangiomas.

The lesions typically present in children and young adults.

Patients may have pain, swelling and/or limited joint mobility. Occasionally patients can have recurrent haemarthroses 8.

The lesions can be cavernous, capillary or mixed. 

Most lesions tend to occur around the knee 1.

Plain film findings are generally non-specific and may be seen as a soft tissue mass adjacent to the knee. Accompanying phleboliths may be present. 

Typically seen as a lobulated intra-articular mass (although the lesions can be either lobulated or diffuse).

  • T1: usually of intermediate signal 4

  • T2 

    • markedly hyperintense background; likely from pooled blood within vascular spaces 4

    • hypointense linear structures within the lesion; likely from fibrous septa or vascular channels 4

    • fluid-fluid levels may be present 

  • T1 C+ (Gd): marked enhancement 5

Imaging differential considerations include:

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