Synovitis on MRI, like the many faced god in Game of Thrones, can have many appearances. However like we saw in the article Tendinosis: Same Same But Different once you recogines the different appearances, its the same pattern for each joint. Synovitis is usually generalised and associated with an effusion, but can also be localised to a portion of the joint and without an effusion. Its not possible to differentiate inflammatory from infective synovitis and contrast wont help as all forms of synovitis will enhance. We are going to look at the common appearances in this section and and then some of the more unusual and sneaky areas that synovitis can hide in the next article.
Image above: First image is the normal appearance posterior to the posterior horn of the meniscus. The following 2 images demonstrate intermediate signal from synovitis lying posterior to the meniscus. Often there is an associated meniscal tear ( 2nd image) which causes the synovitis. When related to a tear, it can be localised just to that area.
In the next section we will look at the places that synovitis can hide in joints and not be readily apparent.