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Current Medical Imaging

Editor-in-Chief

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

Review Article

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

Author(s): Woo Young Kang, Suk-Joo Hong, Ok Hee Woo*, Chang Ho Kang, Kyung-Sik Ahn, Baek Hyun Kim and Euddeum Shim

Volume 20, 2024

Published on: 26 June, 2023

Article ID: e010623217546 Pages: 12

DOI: 10.2174/1573405620666230601114534

open_access

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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