Title:T2 Black Synovitis in Musculoskeletal MRI: Disease Spectrum and Imaging
Characteristics of Joint Diseases
Volume: 20
Author(s): Woo Young Kang, Suk-Joo Hong, Ok Hee Woo*, Chang Ho Kang, Kyung-Sik Ahn, Baek Hyun Kim and Euddeum Shim
Affiliation:
- Department of Radiology, Korea University Guro Hospital, Seoul, Republic of Korea
Keywords:
Magnetic resonance imaging, Synovial membrane, Synovitis, Joint disease, Hemorrhage, Calcification.
Abstract: The synovium may be affected by a wide spectrum of disorders, including inflammatory, infectious, degenerative, traumatic, hemorrhagic, and
tumorous conditions. Magnetic resonance imaging (MRI) is a valuable imaging modality to characterize synovial disorders. Most abnormal lesions
appear as areas of nonspecific high signal intensity on T2-weighted images (T2-WI) due to high water content or increased perfusion. However, T2
hypointensity can be attributed to blood components of varying ages, calcification, inorganic crystals, fibrosis, caseous necrosis and/or amyloid
deposition. Hypointense lesions on T2-WI are infrequent and additional clinical and imaging characteristics can help to limit the list of differential
diagnoses, which may include tenosynovial giant cell tumor, synovial chondromatosis, rheumatoid arthritis, tuberculous arthritis, chronic
tophaceous gout, amyloid arthropathy, synovial hemangioma, lipoma arborescens and hemosiderotic synovitis. Recently, susceptibility weighted
imaging has been developed and may contribute to more accurate diagnosis for deoxygenated blood and calcium. We review the MRI features of
hypointense synovial lesions on MRI and emphasize the characteristic findings that suggest a correct diagnosis.
