Subscribe to RSS
DOI: 10.1055/s-2003-43231
Imaging of Pigmented Villonodular Synovitis
Publication History
Publication Date:
31 October 2003 (online)
ABSTRACT
Pigmented villonodular synovitis (PVNS) is a rare, benign, idiopathic proliferative disorder of the synovium that results in villous and/or nodular formation in joints, tendon sheaths, and bursae. The disease can be localized or diffuse. Patients with this condition typically present with symptoms of mild discomfort and associated stiffness of the involved joint; however, the spectrum of presentations is broad. Diagnosis of PVNS can be clinically difficult, and plain radiographs are usually nonspecific. Magnetic resonance (MR) imaging is a highly diagnostic modality in characterizing PVNS when it contains hemosiderin deposits exhibiting low signal intensity on all MR image pulse sequences. This article discusses the presentation, pathology, differential diagnosis, diagnostic modalities as well as various treatment options of PVNS.
KEYWORDS
Pigmented villonodular synovitis - localized - diffuse - hemosiderin - magnetic resonance
REFERENCES
- 1 Young-in L F. et al . Discrete soft tissue mass in the distal thigh of a 29 years old man. Clin Orthop . 1998; 357 247-250
- 2 Goldman A B, DiCarlo E F. Pigmented villonodular synovitis, diagnosis and differential diagnosis. Radiol Clin North Am . 1988; 26 1327-1347
- 3 Bhimani M A, Wenz J F. Pigmented villonodular synovitis: keys to early diagnosis. Clin Orthop . 2001; 386 197-202
- 4 Dowart R H. et al . Pigmented villonodular synovitis of synovial joints: clinical, pathologic, and radiologic features. Am J Roentgenol . 1984; 143 877-885
- 5 Aboulafia A J. et al . Neuropathy secondary to pigmented villonodular synovitis of the hip. Clin Orthop . 1996; 325 174-180
- 6 Cotton A. et al . Pigmented villonodular synovitis of the hip: review of radiographic features in 58 patients. Skeletal Radiol . 1995; 24 1-6
- 7 Jaffe H L, Lichtenstein L, Sutro C J. Pigmented villonodular synovitis, bursitis and tenosynovitis. Arch Pathol . 1941; 31 731-765
- 8 Flandry F. et al . Roentgenographic findings in pigmented villonodular synovitis of the knee. Clin Orthop . 1989; 247 208-219
- 9 Granowitz S P, D'Antonio J, Mankin H L. The pathogenesis and long term end results of pigmented villonodular synovitis. Clin Orthop . 1976; 114 335-350
- 10 Flandry F, Hughston J C. Current concepts review. Pigmented villonodular synovitis. J Bone Joint Surg Am . 1987; 69A 942-949
- 11 Danzig L A, Gershuni D H, Resnick D. Diagnosis and treatment of diffuse pigmented villonodular synovitis of the hip. Clin Orthop . 1982; 168 42-47
- 12 Docken W P. Pigmented villonodular synovitis: a review with illustrative case reports. Semin Arthritis Rheum . 1979; 9 1-22
- 13 Lin J, Jacobson J A, Jamadar D A, Ellis J H. Pigmented villonodular synovitis and related lesions: the spectrum of imaging findings. Am J Roentgenol . 1999; 172 191-197
- 14 Yang P Y, Wang C L, Wu C T, Wang T G, Hsieh F J. Sonography of pigmented villonodular synovitis in the ankle joint. J Clin Ultrasound . 1998; 26 166-170
- 15 Hughes T H, Sartoris D J, Schweitzer M E, Resnick D L. Pigmented villonodular synovitis: MRI characteristics. Skeletal Radiol . 1995; 24 7-12
- 16 Dale K. et al . Dynamic MR-imaging in the diagnosis of pigmented villonodular synovitis of the knee. Scand J Rheumatol . 2000; 29 336-339
- 17 Durr H R, Stabler A, Maier M, Refior H J. Pigmented villonodular synovitis. Review of 20 cases. J Rheumatol . 2001; 28 1620-1629
- 18 Lowenstein M B, Smith J R, Cole S. Infrapatellar pigmented villonodular synovitis: arthrographic detection. Am J Roentgenol . 1980; 135 279-282
- 19 Shanley D J, Auber A E, Watabe J T, Buckner A B. Pigmented villonodular synovitis of the knee demonstrated on bone scan. Correlation with US, CT, and MRI. Clin Nucl Med . 1992; 17 901-902
- 20 Rosenthal D I, Aronow S, Murray W T. Iron content of pigmented villonodular synovitis detected by computed tomography. Radiology . 1979; 133 409
- 21 Smith J H, Pugh D G. Roentgenographic aspects of articular pigmented villonodular synovitis. Am J Roentgenol . 1962; 87 1146
- 22 Charles E S, Murray K D, Herbert Y K. Magnetic resonance imaging of pigmented villonodular synovitis: a report of two cases. Skeletal Radiol . 1987; 16 316-319
- 23 Patkar D, Prasad S, Shah J, Patankar T, Kothari S. Pigmented villonodular synovitis: magnetic resonance features of an unusual case of bilateral hip joint involvement. Austral Radiol . 2000; 44 458-459
- 24 Resnick D, Niwayama G. Soft tissues. In: Resnick D, ed. Diagnosis of Bone and Joint Disorders Philadelphia: WB Saunders 1995: 4562-4567
- 25 Visser E D, Veth R PH, Pruszczynski M, Wobbes T, Van de Putte B A L. Diffuse and localized pigmented villonodular synovitis: evaluation and treatment of 38 patients. Arch Orthop Trauma Surg . 1999; 119 401-404
- 26 Muscolo D L, Makino A, Costa-Paz M, Ayerza M. Magnetic resonance imaging evaluation and arthroscopic resection of localized pigmented villonodular synovitis of the knee. Orthopedics . 2000; 23 367-369
- 27 Kalil R K, Unni K K. Malignancy in pigmented villonodular synovitis. Skeletal Radiol . 1998; 27 392-395
- 28 Kim S-J. et al . Arthroscopic treatment for localized pigmented villonodular synovitis of the knee. Clin Orthop . 2000; 379 224-230
- 29 Ogilvie-Harris D J, Mclean J, Zarnett M E. Pigmented villonodular synovitis of the knee: the results of arthroscopic synovectomy, partial synovectomy, and arthroscopic local excision. J Bone Joint Surg . 1991; 74A 119-123
- 30 Schwartz H S, Unni K K, Pritchard D J. Pigmented villonodular synovitis. A retrospective review of affected large joints. Clin Orthop . 1989; 247 243-245
- 31 Vedantam R. et al . Polyarticular pigmented villonodular synovitis in a child. Clin Orthop . 1998; 348 208-211