title: An unusual cause of recurrent joint effusions: nonhemophilic hemosiderotic synovitis of the knee.
abstract: A 20-year-old female presented with a painful swelling in the right knee and snapping sensation on joint motion that appeared without trauma and recurred several times. She had no history of a bleeding disease or trauma. Physical examination showed no signs of rash or temperature change or systemic or local findings of an infection. The knee was tender and knee motion was painful, with 90 degrees of flexion and full extension. The ballottement test was positive. All laboratory tests including rheumatologic and bleeding parameters were normal. Joint effusion analysis was normal except for its rusty-brown color. Magnetic resonance imaging showed synovial hypertrophy and grade 2 degeneration in the medial meniscus. During diagnostic and surgical arthroscopy, rust-colored synovial hypertrophy was noted in the suprapatellar pouch accompanied by patchy villi and nodules and cystic changes. The gross appearance of the synovium mimicked that of pigmented villonodular synovitis. Biopsy specimens were obtained from different parts of the synovium and a subtotal synovectomy was performed. The histopathologic diagnosis was reported as hemosiderotic synovitis. During a three-year follow-up, she had no pain, snapping sensation, or limitation of motion. There were no recurrent effusions.
authors.affiliation: Department of Orthopedics and Traumatology, Ankara Atatürk Training and Research Hospital, Ankara. drmnyalcin@yahoo.com
authors.forename: Nadir
authors.initials: N
authors.lastname: Yalçin
authors.forename: Bülent
authors.initials: B
authors.lastname: Bektaşer
authors.forename: Ozgür
authors.initials: O
authors.lastname: Ciçekli
authors.forename: Serdar
authors.initials: S
authors.lastname: Uğraş
authors.forename: Metin
authors.initials: M
authors.lastname: Doğan
mesh_terms: D005260:Female; D006485:Hemosiderin / Q000032:analysis; D006801:Humans; D007719:Knee Joint / Q000473:pathology / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008592:Menisci, Tibial / Q000473:pathology; D000074402:Synovectomy; D013583:Synovial Membrane / Q000473:pathology; D013586:Synovitis, Pigmented Villonodular / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D055815:Young Adult
chemical_list: D006485:Hemosiderin