48F hx of Diabetes Mellitus and “Kidney Disease” (not specified) 1.5 months
medial pain and swelling, no trauma
Obvious smooth erosion with local bright T2 signal in and superficial to
erosion and marked reactive BME and soft tissue edema at the posteromedial
knee.
I don’t see a local calcific deposit (don’t have XR)…dark signal in the
Ax plane corresponds to normal appearing dark capsule in the Sag images.
There is a small calcific deposit adjacent to the posterolateral wall if
the IC notch.
Can I know if this is Resorptive Phase (immediately post resorptive)
HADD…or if this is Gout, in someone who happens to also have a separate
calcific deposit?
[image: 48F 1.5m med pain sts DM kidney dz nos gout v hadd.jpg]
[image: 48F 1.5m med pain sts DM kidney dz nos gout v hadd (1).jpg]
[image: 48F 1.5m med pain sts DM kidney dz nos gout v hadd (2).jpg]
[image: 48F 1.5m med pain sts DM kidney dz nos gout v hadd (3).jpg]
[image: 48F 1.5m med pain sts DM kidney dz nos gout v hadd (4).jpg]
[image: 48F 1.5m med pain sts DM kidney dz nos gout v hadd (5).jpg]
Sorry, I don’t have any labs.
—I have several cases where the degree of reactive marrow and soft tissue
edema (usually without bone erosion like this) suggests HADD to me, but I
can’t find a calcification—even with radiographs on the same or next
day. I don’t know how they evolve clinically….if it is HADD, I suppose
they will get better over time, post resorption.
What do you think?
