Posted: Apr 30 2016 #(C2581) SEC - Deputy Editors Private Group

Unknown Intra-Articular Knee Mass in 15-year old

HPI

15 year old with 4 months of anterior left knee pain. there is pain consistent with typical patellofemoral pain syndrome in an adolescent. there is pain along the medial plica region and palpable mass similar to lipoma. no constitutional symptoms or injury starting the pain. XR and MR arthrogram shown.

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What is the most likely diagnosis?

1 plica

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2 intraarticular synovial sarcoma

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3 intraarticular lipoma

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4 pigmented villonodular synovitis

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5 localized nodular synovitis

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6 lipoma arborescens

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7 synovial osteochondromatosis

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P: 8939

What is the next step in evaluation?

1 none needed. proceed with knee arthroscopy

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2 none needed. observation only

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3 chest CT and MRI of entire femur

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4 open biopsy

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5 fine needle aspiration biopsy

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6 MRI with IV contrast

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P: 8940

What is the best treatment?

1 observation

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2 knee arthroscopy and debridement of lesion/synovectomy

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3 open resection of lesion

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4 wide resection and adjuvant radiotherapy

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P: 8941

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