Synovial involvement in hemangiomatosis.
BACKGROUND
Angiodysplastic lesions of the extremities are very often of great interest for the orthopedist, involving not only bones with length discrepancy, but also joints with hemarthrosis and synovial hypertrophy.


METHODS
We describe 4 patients with cutaneous hemangiomatosis in the lower limb and a concomitant knee arthropathy. Like in other arthropathies, the articular damage is rapidly invasive and leads to progressive damage in the joint if not adequately diagnosed and treated. We treated the 4 patients at different ages, corresponding to different stages of intra-articular involvement. The preoperative management included MRI and diagnostic arthroscopy. All patients underwent an open synovectomy. All our patients were reviewed at a clinical and radiographic follow-up after 10 years.


RESULTS
In all patients, the range of motion was improved or at least not worsened after surgery, in spite of a larger extent of cutaneous lesions. X-ray and MRI confirmed clinical data showing no recurrence of the lesion inside the joint and no progression of the articular damage.


CONCLUSIONS
The clinical outcomes were very good or good in the patients treated early, poorer in the patient operated on at an adult age. The importance of an early and precise diagnosis and of an accurate preoperative planning must be underlined.
Department of Medical and Surgical Specialities, Section of Orthopedics and Traumatology, University of Padova, Via Giustiani 2, 35128 Padova, Italy. cosbardi@tin.it
Stefano
S
Bonaga
Costantino
C
Bardi
Cosimo
C
Gigante
Sisto
S
Turra
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D006391:Hemangioma / Q000150:complications* / Q000601:surgery; D006801:Humans; D007592:Joint Diseases / Q000209:etiology; D007715:Klippel-Trenaunay-Weber Syndrome / Q000150:complications* / Q000601:surgery*; D007719:Knee Joint / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D016059:Range of Motion, Articular; D012878:Skin Neoplasms / Q000150:complications* / Q000601:surgery; D013583:Synovial Membrane / Q000473:pathology*