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DIAGNOSIS:

Hemophilic Arthropathy

Fig. 6: DESS coronal MRI of the knee shows low signal in the synovium (arrow) due to hemosiderin, suggesting repeated hemorrhages.	Fig. 7: Plain radiograph of the knee in the frontal projection shows a bicompartmental arthropathy with marked widening of the intercondylar fossa
Fig. 8: Skyline view of the patella shows patello-femoral arthropathy with intercondylar fossa widening.

The MRI images show a tri-compartmental arthropathy with cartilage loss and subchondral marrow edema. There is marked widening of the intercondylar fossa.

The gradient images (Figs. 3-5 & 6) show low signal in the synovium with blooming suggestive of hemosiderin, which in turn suggests repeated hemorrhage.

This combination of findings is highly suggestive of hemophilic arthropathy, which is confirmed on the plain radiographs (Figs. 6, 7).

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PubMed References for Hemophilic Arthropathy

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The following radiologists have answered this quiz correctly.

Names

Edmund Moses

Rajal Choudhary

Rajneesh Galwa

Rakshit Kumar

Ram Prakash Galwa

Shilpa Sankhe