Giant intraosseous cyst-like lesions in rheumatoid arthritis report of a case.
The term "intraosseous synovial cyst" is used to designate both the epiphyseal cyst-like lesions seen in patients with rheumatoid arthritis (RA) and mucoid cysts, which occur in a different setting. We report the case of a patient in whom a 4-cm cyst-like lesion developed in the left tibia 18 years after onset of RA and 6 years after osmic acid synovectomy of the left knee. Positive contrast arthrography and magnetic resonance imaging visualized a communication between the lesion and the joint space. Preexisting bone and joint lesions and increased intraarticular pressure play a major role in the genesis of cyst-like lesions in RA. In our patient, the osmic acid synovectomy may have contributed to the development of the lesion. "Synovial cyst" is a misnomer for these giant lesions, which are geodes rather than cysts. Despite their low incidence, these lesions deserve attention because they raise diagnostic and therapeutic problems.
Lohse
Anne
A
Rheumatology department, CHU Jean-Minjoz, 25030 Besançon cedex, France.
Carbillet
Jean-Pierre
JP
Onimus
Michel
M
Stevenel
Françoise
F
Toussirot
Eric
E
Wendling
Daniel
D
D001172:Arthritis, Rheumatoid / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology; D001845:Bone Cysts / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D011183:Postoperative Complications; D011859:Radiography; D000074402:Synovectomy; D013581:Synovial Cyst / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology; D009626:Terminology as Topic; D013977:Tibia / Q000000981:diagnostic imaging / Q000473:pathology