Synovial Hemangioma Presenting as Anterior Knee Pain - A Case Series

INTRODUCTION: Synovial hemangioma is a benign soft-tissue tumor of vascular origin. The knee joint is most common joint affected and with highest incidence noted till date. For diagnosis, of such rare presentation radiological investigations such as digital radiograph and magnetic resonance imaging are of utmost importance, and magnetic resonance imaging being considered as investigation of choice. The gold standard treatment being complete excision of the growth. CASE 1: A 13-year-old boy presented in out-patient clinic with chief complaint of right sided anterior knee pain since 10 months and patient had history of trauma in past. Magnetic resonance imaging of knee joint showed well circumscribed lesion in infra-patellar area (Hoffa’s fat pad), with internal septations present within lesion. CASE 2: A 25-year-old female presented to out-patient clinic with chief complaint of left sided anterior knee pain since 2 year, with no history of prior injury. The magnetic resonance imaging of knee joint showed ill-defined lesion around anterior patella-femoral articulation adherent to quadriceps tendon, internal septations present within lesion. For both cases, en bloc excision was performed and good functional outcome was achieved. CONCLUSION: Knee joint synovial hemangioma is rare presentation to orthopedic outdoors, has slight female predominance with pre-existing history of trauma. In the present study, both cases were of patella-femoral type (anterior and infra-patellar fat pad). For such lesions, en bloc excision is gold standard procedure to prevent recurrence, same procedure was followed in our study, and good functional outcome was achieved.