SYNOVIAL CYST OF THE SHOULDER JOINT IN THE BICIPITAL AREA IN JUVENILE RHEUMATOID ARTHRITIS

Masafumi Homma, M.D.,D.M.Sc, Research Fellow of Orthopaedic Surgery

William G. Mackenzie, M.D.,FRCS(C), Attending of Pediatric Orthopaedic Surgery

July 26, 1995

CLINICAL CASE PRESENTATION

ORTHOPAEDIC DEPARTMENT

THE ALFRED I. DUPONT INSTITUTE

WILMINGTON, DELAWARE

CASE HISTORY:
DISCUSSION:

In this case, the synovial cyst was noticed while the synovitis was well controlled atypical for synovial cysts. Several factors made the diagnosis difficult in this case. The clinical findings and ultrasound suggested a solid tumor. Sonography of a synovial cyst filled with proteinaceous material would show intermediate signal intensity, so that it may be confused with solid tissue mass. MRI was useful in this case in suggesting a connection between shoulder joint and the mass but this connection may not always be seen. An arthrogram may be indicated in similar cases prior to surgical intervention such as needle or open biopsy. Synovial cysts should be considered in the differential diagnosis of upper extremity soft tissue tumors in children with JRA.

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