Case Challenge

Knee

Gain confidence interpreting Knee MRI Cases with MRI Online. Quiz yourself using real-world, interactive scrollable cases & earn CME. Try it free!

Case Review

Musculoskeletal (MSK)

Case 1 - 54-year-old male presents with right knee pain

Case 2 - 29-year-old female presents with left knee pain

Case 3 - 53-year-old female presents with posteromedial right knee mass

Case 4 - 30-year-old male presents with right knee pain after motor vehicle accident

Case 5 - 17-year-old male has patellar pain in his right knee

Case 6 - 57-year-old male presents with large mass on right knee

Case 7 - 10-year-old presents with right knee pain and swelling

Case 8 - 12-year-old female presents with left knee pain

Case 9 - 27-year-old male presents with pain and swelling in left knee

Case 10 - 57-year-old male presents with medial right knee pain

Course Evaluation

Post-Course Activities

This Power Pack is comprised of 10 unique Knee MRI cases that you can scroll through in our diagnostic web viewer to determine your findings. Quiz yourself and earn CME.

Knee MRI Cases

<div>History: This 54-year-old male presents with right knee pain that has continued for a year with no known injury.MOST LIKELY DIAGNOSIS: Primary synovial chondromatosisUsing the diagnostic web viewer, we have provided images that assist in telling our clinical story. Areas of significance are indicated below.<figure class="wp-block-image"><img src="https://process.fs.teachablecdn.com/ADNupMnWyR7kCWRvm76Laz/resize=width:750/https://www.filepicker.io/api/file/0xNxaQVJQPVDTo4D1uX4" alt=""></figure>CLINICAL CONSIDERATIONS:The most likely diagnosis is primary synovial chondromatosis. Synovial chondromatosis is a rare monoarticular process characterized by cartilaginous bodies. Primary synovial chondromatosis has a predilection for the large joints, including the knee, hip, elbow, and shoulder, although it can be identified in any joint or tendon. It affects males more frequently than females, and it is most common in the third to fifth decades. The MRI signal characteristics of the intraarticular bodies varies depending on the amount of calcification and / or ossification (images 2 and 3, yellow and orange arrows). Rare, but primary synovial chondromatosis can undergo malignant degeneration.CLINICAL CONSIDERATIONS:What is the differential diagnosis for the intraarticular bodies?Secondary synovial chondromatosis is more common than primary synovial chondromatosis. It usually presents in the setting of longstanding osteoarthritis. In this patient, note that the medial and lateral compartments of the joint space are preserved. Only a small marginal erosion of the medial tibial plateau is noted (image 1, green arrow). Secondary synovial chondromatosis does not undergo malignant degeneration.Rice bodies would be an unlikely consideration in this individual who is male, middle-aged, and presents with a monoarticular arthritis as rice bodies are commonly identified in inflammatory arthropathies such as rheumatoid arthritis and tuberculous infections. They are smaller than synovial chondromatosis. Other intraarticular masses to potentially consider are pigmented villonodular synovitis (PVNS) which has diffuse and focal forms, and would not present as nodular densities, but as a mass. Blooming may occur on gradient images due to a lack of refocusing pulse on this sequence, and due to siderotic components. Lipoma arborescens is most commonly found in the suprapatellar bursa and follows fat signal. Synovial hemangiomas are typically high in signal on T2-weighted images.</div>

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