Case 5

This is a shoulder MRI study showing diffuse, nodular synovial thickening with frond-like projections and nodules- the synovial nodules show very low signal intensity on the T2 weighted images, and blooming artifact on the gradient echo / susceptibility weighted sequences. There are also a few minor erosions of the humeral head. The findings are most in keeping with pigmented villonodular synovitis. I would correlate with the clinical history, consider administering contrast to differentiate thickened synovium – which would enhance strongly- from joint effusion fluid, and notify the referring physician of the diagnosis. The differential diagnosis for this case includes haemophiliac haemarthropathy- which only affects haemophiliac patients.