Abstract
Synovial tumors and tumorlike conditions may arise from or extend into any synovial lined structure such as joints, bursae, and tendon sheaths. Radiography and CT play an important role in the workup of musculoskeletal pathologies. Although MRI is the gold standard for assessing the synovium, changes in radiographic densities are ready discernable on radiography and CT, which can alert the radiologist, prompting further investigation to eliminate a sinister cause and on the other hand to dismiss a non-sinister pathology avoiding further unnecessary investigations and most importantly patient reassurance. Fat planes and bursae are routinely visualized on radiography and CT and provide anatomical landmarks, where the pathology may be arising from or extending into, with CT providing higher resolution and more specific anatomical boundaries. The aim of the chapter is to discuss the radiographic and CT (DECT where relevant) appearances of synovial tumors and tumorlike conditions and highlight key imaging differentials where pathologies overlap in their imaging features.
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References
Bhadra A, Pollock R, Tirabosco RP, Skinner JAM, Cannon SR, Briggs TWR, Flanagan AM (2007) Primary tumours of the synovium—a report of four cases of malignant tumour. J Bone Joint Surgery Br 89:1504
Biazzo A, Confalonieri N (2016) Synovial chondrosarcoma. Ann Transl Med 4:280
Calvisi V, Zoccali C (2016) Arthroscopic patterns of the poster-medial aspect of the knee joint: classification of the gastrocnemius-semimembranosus gateway and its relationship with Baker’s cyst. Muscles Ligaments Tendons J 6:492–498
Chang L-R, Anand P, Varacallo M (2021) Anatomy, shoulder and upper limb, glenohumeral joint. In: StatPearls. StatPearls Publishing, Treasure Island, FL
Christiansen S, Müller FC, Østergaard M, Slot O, Møller JM, Børgesen HF, Gosvig KK, Terslev L (2020) Dual-energy CT in gout patients: do all colour-coded lesions actually represent monosodium urate crystals? Arthritis Res Ther 22:212
Dalbeth N, Pool B, Gamble GD, Smith T, Callon KE, McQueen FM, Cornish J (2010) Cellular characterization of the gouty tophus: a quantitative analysis. Arthritis Rheum 62:1549–1556
Davis R, Hamilton A, Biggart JD (1998) Primary synovial chondromatosis: a clinicopathologic review and assessment of malignant potential. Hum Pathol 29:683–688
Flohr TG, McCollough CH, Bruder H, Petersilka M, Gruber K, Süss C, Grasruck M, Stierstorfer K, Krauss B, Raupach R, Primak AN, Küttner A, Achenbach S, Becker C, Kopp A, Ohnesorge BM (2006) First performance evaluation of a dual-source CT (DSCT) system. Eur Radiol 16:256–268
Friere V, Moser TP, Lepage-Saucier M (2018) Radiological identification and analysis of soft tissue musculoskeletal calcifications. Insights Imaging 9:477–492
Geijer M, Inci F, Solidakis N, Szaro P, Al-Amiry B (2021) The development of musculoskeletal radiology for 100 years as presented in the pages of Acta Radiologica. Acta Radiol 62:1460–1472
Guerra J, Newell J, Resnick D, Danzig LA (1981) Gastrocnemio-semimembranosus bursal region of the knee. Am J Roentgenol 136:593–596
Johnson TR (2012) Dual-energy CT: general principles. AJR Am J Roentgenol 199:S3–S8
Johnson T, Fink C (2011) Dual energy CT in clinical practice. Springer Science & Business Media, Berlin
Johnson TR, Krauss B, Sedlmair M, Grasruck M, Bruder H, Morhard D, Fink C, Weckbach S, Lenhard M, Schmidt B, Flohr T, Reiser MF, Becker CR (2007) Material differentiation by dual energy CT: initial experience. Eur Radiol 17:1510–1517
Larbi A, Viala P, Cyteval C, Snene F, Greffier J, Faruch M, Beregi J-P (2016) Imaging of tumors and tumor-like lesions of the knee. Diagn Interv Imaging 97(7–8):767–777
Lindgren PG, Willén R (1977) Gastrocnemio-semimembranosus bursa and its relation to the knee joint: I. Anatomy and histology. Acta Radiol Diagn (Stockh) 18:497–512
Mallinson P, Coupal TM, McLaughlin PD, Nicolaou S, Munk PL, Ouellette HA (2016) Dual-energy CT for the musculoskeletal system. Radiology 281(3):690
Manaster BJ (2016) Diagnostic imaging: musculoskeletal non-traumatic disease, 2nd edn. Elsevier
Meraj S, Bencardino JT, Steinbach L (2014) Imaging of cysts and bursae. Semin Musculoskelet Radiol 18:436–447
Mitchell MJ, Causey G, Berthoty DP, Sartoris DJ, Resnick D (1988) Peribursal fat plane of the shoulder: anatomic study and clinical experience. Radiology 168:699–704
Morris B, Byram IR, Lathrop RA, Dunn WR, Kuhn JE (2014) Mapping the articular contact area of the long head of the biceps tendon on the humeral head. Anat Res Int 2014:814721
Murphey M, Vidal JA, Fanburg-Smith JC, Gajewski DA (2007) Imaging of synovial chondromatosis with radiologic-pathologic correlation. Radiographics 21(5):1465
Nisolle JF, Blouard E, Baudrez V, Boutsen Y, De Cloedt P, Esselinckx W (1999) Subacromial-subdeltoid lipoma arborescens associated with a rotator cuff tear. Skelet Radiol 28:283–285
Omoumi P, Zufferey P, Malghem J, So A (2016) Imaging in gout and other crystal-related arthropathies. Rheum Dis Clin N Am 42:621–644
Rauschning W (1980) Anatomy and function of the communication between knee joint and popliteal bursae. Ann Rheum Dis 39:354–358
Resnick D, Broderick TW (1981) Intraosseous calcification in tophaceous gout. AJR Am J Roentgenol 137:1157–1161
Ruangchaijatuporn T, Gaetke-Udager K, Jacobson JA, Yablon CM, Morag Y (2017) Ultrasound evaluation of bursae: anatomy. Skelet Radiol 46:445–462
Rugg CM, Hettrich CM, Ortiz S, Wolf BR, MOON Shoulder Instability Group, Zhang AL (2018) Surgical stabilization for first-time shoulder dislocators: a multicenter analysis. J Shoulder Elb Surg 27:674–685
Schraner AB, Major NM (1999) MR imaging of the subcoracoid bursa. AJR Am J Roentgenol 172:1567–1571
Sheldon P, Forrester DM, Learch TJ (2005) Imaging of intrarticular masses. Radiographics 25:105–119
Tanikawa H, Ogawa R, Okuma K, Harato K, Niki Y, Kobayashi S, Nagura T (2018) Detection of calcium pyrophosphate dihydrate crystals in knee meniscus by dual-energy computed tomography. J Orthop Surg Res 13:73
Towbin R, Dunbar JS, Towbin J, Clark R (1980) Teardrop sign: plain film recognition of ankle effusion. AJR Am J Roentgenol 134:985
Turan A, Çeltikçi P, Tufan A, Öztürk MA (2017) Basic radiological assessment of the synovial diseases: pictorial essay. Eur J Rheumatol 4:166–174
Walker EA, Murphey MD, Fetsch JF (2011) Imaging characteristics of tenosynovial and bursal chondromatosis. Skelet Radiol 40:317–325
WHO Classification of Tumours (2020) Soft tissue and bone tumours. International Agency for Research on Cancer, Lyon
Wittkop B, Davies A, Mangham D (2002) Primary synovial chondromatosis and synovial chondrosarcoma: a pictorial review. Eur Radiol 12:2112–2119
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Thanks go to Mr. Andy Biggs, Medical Illustrations Department, RJAH.
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Khalid, K., Lalam, R., Kaur, S. (2023). Radiography and CT in Synovial Tumors and Tumorlike Conditions. In: Vanhoenacker, F.M., Ladeb, M.F. (eds) Imaging of Synovial Tumors and Tumor-like Conditions. Medical Radiology(). Springer, Cham. https://doi.org/10.1007/174_2023_411
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DOI: https://doi.org/10.1007/174_2023_411
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