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Current Medical Imaging

Current Medical Imaging

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ISSN (Print): 1573-4056
ISSN (Online): 1875-6603

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Review Article

T2 Black Synovitis in Musculoskeletal MRI: Disease Spectrum and Imaging Characteristics of Joint Diseases

Author(s): Woo Young Kangorcid of author, Suk-Joo Hongorcid of author, Ok Hee Woo*orcid of author, Chang Ho Kangorcid of author, Kyung-Sik Ahnorcid of author, Baek Hyun Kimorcid of author and Euddeum Shimauthors OrcID

Volume 20, 2024

Published on: 26 June, 2023

Article ID: e010623217546

Pages: 12

DOI: 10.2174/1573405620666230601114534

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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.

Keywords: Magnetic resonance imaging, Synovial membrane, Synovitis, Joint disease, Hemorrhage, Calcification.

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