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. 2021 Jun 24;92(6):753–759. doi: 10.1080/17453674.2021.1941624

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© 2021 The Author(s). Published by Taylor & Francis on behalf of the Nordic Orthopedic Federation.

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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graphic file with name IORT_A_1941624_F0002a_B.jpg — Case no. 10. A 37-year-old female with an infrapatellar infiltrative soft tissue lesion of the knee. (A) Proton density (PD) image shows irregular heterogeneous soft tissue lesion in subcutaneous tissue just anterior to patellar ligament with surrounding edema (white arrow) and joint effusion. (B) Homogenous hypointense signal intensity on T1-weighted image (white arrow). (C) Axial PD image shows the hyperintense lesion and extension of soft tissue edema (white arrow). (D) Sagittal T1 VIBE image after application of Gd-contrast shows homogenous contrast enhancement of the lesion with an irregular margin (white arrow). On all sequences, the patellar ligament is intact. (E–F) Histology shows fatty tissue with extensive fibrosis and numerous granulomas with central necrosis. (G–H) Central necrosis (black stars) is often stellate in appearance with admixed neutrophils and surrounded by palisading histiocytes (black arrows, H).

graphic file with name IORT_A_1941624_F0002b_C.jpg — Case no. 10. A 37-year-old female with an infrapatellar infiltrative soft tissue lesion of the knee. (A) Proton density (PD) image shows irregular heterogeneous soft tissue lesion in subcutaneous tissue just anterior to patellar ligament with surrounding edema (white arrow) and joint effusion. (B) Homogenous hypointense signal intensity on T1-weighted image (white arrow). (C) Axial PD image shows the hyperintense lesion and extension of soft tissue edema (white arrow). (D) Sagittal T1 VIBE image after application of Gd-contrast shows homogenous contrast enhancement of the lesion with an irregular margin (white arrow). On all sequences, the patellar ligament is intact. (E–F) Histology shows fatty tissue with extensive fibrosis and numerous granulomas with central necrosis. (G–H) Central necrosis (black stars) is often stellate in appearance with admixed neutrophils and surrounded by palisading histiocytes (black arrows, H).