PMC4290066_01
Photographic picture of the swelling in the left knee joint
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F1
Swelling was involving mainly the suprapatellar fossa with mild pain present [Figure 1].
Magnetic resonance imaging of the left knee joint showing numerable finger like projections appearing hypointense in all pulse sequence is seen diffusely along the synovial membrane of left knee joint, more in suprapatellar synovial recess with tense joint effusion
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F2
Magnetic resonance imaging (MRI) of knee joint [Figure 2] was done, which showed innumerable finger like projections appearing hypointense in all pulse sequence is seen diffusely along the synovial membrane of left knee joint, more in suprapatellar synovial recess with tense joint effusion, suggesting PVNS.
Three phase bone scintigraphy of knee joint. Perfusion (a) and anterior and posterior blood pool (b) images demonstrates increased perfusion and blood pool concentration in left knee joint consistent with synovitis
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F3
Three phase bone scintigraphy showed perfusion phase [Figure 3] demonstrating increased perfusion in the left knee joint and blood pool images shows increased blood pooling consistent with synovitis.
Whole body images (a) showing increased tracer uptake in the left knee joint
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F4
Whole body images [Figure 4] showed increased uptake in left knee joint.
Joint aspiration revealing hemorrhagic fluid
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F5
Knee joint aspiration just before the Y-90 HA administration revealed brownish discoloration of the fluid due to the breakdown of blood products (hemosiderin) within the joint [Figure 5].
Yttrium-90 hydroxyapatite bremsstrahlung images of knee joint showing good tracer distribution in the left knee joint
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F6
Imaging of bremsstrahlung of Y-90 activity distribution with a dual head gamma camera showed appropriate homogeneously intra-articular distribution of the radionuclide within the joint space [Figure 6].