ObjectivesTo investigate the ultrasound findings of the synovial hemangioma of knee (SHK) and to evaluate its value in clinical diagnosis.MethodsThe ultrasonographic manifestations and clinical data of 10 patients with SHK confirmed by surgery and pathology were retrospectively analyzed and compared with MRI findings, surgery and pathological results.ResultsSeven cases of SHK (6 cases of diffuse type, 1 case of limited type) were assessed by ultrasound, including 1 case of vascular origin, 1 case of supraorbital sac origin, 1 case with pigmented villonodular synovitis, 1 case with thrombosis, 2 cases accompanied with bone erosion and osteophyte formation, and 3 cases with joint cavity effusion. Ultrasonic findings of SHK were as followed: 7 cases of SHK were manifestate as diffuse mass with unclear boundary, irregular shape and uneven echo mass; 5 cases had mixed-echo mass with reticular structures inside, an increased volume in erect position and positive CDFI compression test; 1 case had heterogeneous hypoechoic mass with a nodular appearance and the positive compression test; 1 case as poorly-demarcated, irregular shape, heterogeneous hyperechoic mass without obvious blood flow signals under the compression test. There were no characteristic ultrasonic findings from other 3 cases of SHK.ConclusionsDiffuse SHKs have characteristic ultrasonograms. SHKs with localized and significant synovial hyperplasia have no specific ultrasonic manifestation and are easily misdiagnosed. Ultrasound is convenient, noninvasive and inexpensive. It can accurately evaluate the involvement of knee joint capsule and surrounding soft tissues. It can be used as the first line diagnostic modality for routine scanning of SHKs.
ObjectiveTo compare the mid-term effectiveness of arthroscopy versus conservative treatment on symptomatic discoid lateral meniscus (SDLM) in middle-aged and elderly patients. Methods The clinical data of 118 middle-aged and elderly patients (154 knees) with SDLM who received arthroscopy or conservative treatment between June 2014 and May 2016 were retrospectively analyzed, including 76 patients (96 knees) in the arthroscopy group (group A) and 42 patients (58 knees) in the conservative treatment group (group B). There was no significant difference in age, gender, and body mass index between the two groups (P>0.05). Compared with group B, the symptoms duration in group A was longer, the incidences of discoid lateral meniscus injury and mechanical symptoms were higher, and the visual analogue scale (VAS) score and Lysholm score before treatment were worse, with significant differences (P<0.05). VAS score and Lysholm score before and after treatment were recorded and compared. ResultsThe patients in both groups were followed up 60-74 months, with an average of 66.3 months. The follow-up time of group A and group B was (65.9±3.5) months and (67.0±4.0) months respectively, with no significant difference (t=–1.615, P=0.109). At last follow-up, in either group A or group B, the VAS score and Lysholm score significantly improved when compared with those before treatment (P<0.05). The differences of VAS score and Lysholm score in group A before and after treatment were significantly better than those in group B (P<0.05). ConclusionArthroscopy and conservative treatment have a satisfactory mid-term effectiveness on SDLM in middle-aged and elderly patients. However, the improvement of symptoms and function of arthroscopy was significantly better than that of conservative treatment. For middle-aged and elderly SDLM patients with invalidated conventional treatment for 6 months, severe clinical symptoms, long duration of symptoms, and combined with mechanical symptoms, arthroscopy should be given priority even if they are complicated with early osteoarthritis.