![54-year-old woman with a painful nodule in the medial right knee. Initial (A & B) MR images show a well-defined cystic lesion deep to the medial patellar retinaculum with fluid–fluid levels (arrows) containing hemorrhage and/or debris, so named the “bowl of grapes” sign. Based on the intra-articular location, this was misdiagnosed as a hemorrhagic parameniscal cyst. Arthroscopic resection was performed and surgical biopsy revealed a grade 3 biphasic synovial sarcoma. C, The patient developed local recurrence 3 years later, manifested by a painful nodule in the resection bed (arrow).

Wang DJ, Alwafi L, Pritchett SL, Wehrli BM, Spouge ARI. The Imaging Spectrum of Synovial Sarcomas: A Pictorial Review From a Single-Centre Tertiary Referral Institution. Canadian Association of Radiologists Journal. 2021;72(3):470-482. doi:10.1177/0846537119899284](attachment:dc8f0402-30d7-4129-907c-a2935a5f4f54:images_large_10.1177_0846537119899284-fig8.jpeg)

54-year-old woman with a painful nodule in the medial right knee. Initial (A & B) MR images show a well-defined cystic lesion deep to the medial patellar retinaculum with fluid–fluid levels (arrows) containing hemorrhage and/or debris, so named the “bowl of grapes” sign. Based on the intra-articular location, this was misdiagnosed as a hemorrhagic parameniscal cyst. Arthroscopic resection was performed and surgical biopsy revealed a grade 3 biphasic synovial sarcoma. C, The patient developed local recurrence 3 years later, manifested by a painful nodule in the resection bed (arrow).

Wang DJ, Alwafi L, Pritchett SL, Wehrli BM, Spouge ARI. The Imaging Spectrum of Synovial Sarcomas: A Pictorial Review From a Single-Centre Tertiary Referral Institution. Canadian Association of Radiologists Journal. 2021;72(3):470-482. doi:10.1177/0846537119899284