Case 2

This is an MRI knee study showing a large suprapatellar joint effusion which appears bright on the T2 and PD series and dark on T1 – within the effusion there is frondlike or villous tissue which is bright on T1 and T2, and exhibits fat suppression on the PD fat sat series, indicating that this is fatty tissue.

There is no blooming artifact on the T2* series, ruling out PVNS. This appearance is characteristic of lipoma arborescens.

There is also horizontal high PD signal in the body of the lateral meniscus reaching the tibial plateau, indicating a degenerative horizontal tear; I note cystic changes / interosseous ganglia in the posterior intercondylar region of the tibia at the attachment of the PCL, showing high SI on PD and low on T1.

I would flag this study for discussion at orthopaedic MDT.