PMC4511697_01
Increased volume in the left knee.
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On physical examination, she had bilateral genu valgus, with swelling in the left knee (Fig. 1).
Radiographs of the left knee in AP (A) and lateral views showing degenerative changes (B).
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Plain radiographs of the knee showed reduced medial joint space, subchondral sclerosis, and reactional osteophytes (Fig. 2).
Magnetic resonance imaging in sagittal (A), coronal (B) and axial (C) slices, depicting the villous and lipomatous appearance of the synovial membrane.
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MRI demonstrated a large joint effusion, thickening of synovial membranes with enhancement after contrast medium with finger-like aspect and lipomatous content on the lateral aspect of the joint, besides degenerative chondral compartmental changes and degeneration in the body of the medial meniscus (Fig. 3).
Intraoperative macroscopic appearance of the lesion (A and B): diffuse villous projections with reddish color, located predominantly in the lateral gutter.
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Besides compartmental degenerative lesions, the arthroscopic examination revealed synovitis of pedunculated appearance and a reddish, diffuse color, with predominance in the lateral gutter (Fig. 4).