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Pigmented villonodular synovitis

Cirivello MJC - MedPix (2007)

View Article: MedPix Image - MedPix Case

Affiliation: Uniformed Services University

ABSTRACT

Diagnosis: Pigmented villonodular synovitis

History: A 36 y/o Caucasian woman presented with a chief complaint of pain & swelling in her left knee for three months. She denied history of trauma or exercise. Her past medical history was non-contributory. Review of systems is negative for fever, fatigue, adenopathy, weight loss, morning stiffness, or night pain.

Findings: Radiographs: Bilateral weight-bearing anterior-posterior and lateral radiographs showed an increased density within the soft tissues of the left knee joint. The bones were well mineralized with smooth borders and no erosions. MRI :T2 weighted with fat saturation MR images of the left knee showed multiple low-signal-intensity masses in the anterior and posterior knee. There was a large high-signal-intensity effusion present on axial & sagittal T2 sequences. The presence of hemosiderin within the mass demonstrated a low-signal intensity rim and “blooming” artifact on gradient-recalled echo and was better delineated than on the T2 weighted images. There was no evidence of erosion or osseous infiltration on any sequence.

Ddx: Pigmented villonodular synovitis Synovial sarcoma Lipoma Arborescens Synovial chrondromatosis Hypertrophic synovitis

Dxhow: Tissue biopsy

Exam: Physical exam revealed decreased range of motion in the left knee greater on flexion & a moderate effusion without erythema or warmth. There was a tender mass palpable at the anterior medial and lateral joint lines. Arthrocentesis of the joint revealed gross blood but fluid analysis proved otherwise unremarkable. Erythrocyte sedimentation rate, c-reactive protein, prothrombin time, & activated partial thromboplastin time were all within normal limits.

No MeSH data available.


Lateral radiograph of the left knee shows an increased density within the soft tissues surrounding the left knee joint. The bones were well mineralized with smooth borders and no erosions.
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MPX1935_synpic34308: Lateral radiograph of the left knee shows an increased density within the soft tissues surrounding the left knee joint. The bones were well mineralized with smooth borders and no erosions.


Pigmented villonodular synovitis

Cirivello MJC - MedPix (2007)

Lateral radiograph of the left knee shows an increased density within the soft tissues surrounding the left knee joint. The bones were well mineralized with smooth borders and no erosions.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=MPX1935&req=5

MPX1935_synpic34308: Lateral radiograph of the left knee shows an increased density within the soft tissues surrounding the left knee joint. The bones were well mineralized with smooth borders and no erosions.

View Article: MedPix Image - MedPix Case

Affiliation: Uniformed Services University

ABSTRACT

Diagnosis: Pigmented villonodular synovitis

History: A 36 y/o Caucasian woman presented with a chief complaint of pain & swelling in her left knee for three months. She denied history of trauma or exercise. Her past medical history was non-contributory. Review of systems is negative for fever, fatigue, adenopathy, weight loss, morning stiffness, or night pain.

Findings: Radiographs: Bilateral weight-bearing anterior-posterior and lateral radiographs showed an increased density within the soft tissues of the left knee joint. The bones were well mineralized with smooth borders and no erosions. MRI :T2 weighted with fat saturation MR images of the left knee showed multiple low-signal-intensity masses in the anterior and posterior knee. There was a large high-signal-intensity effusion present on axial & sagittal T2 sequences. The presence of hemosiderin within the mass demonstrated a low-signal intensity rim and “blooming” artifact on gradient-recalled echo and was better delineated than on the T2 weighted images. There was no evidence of erosion or osseous infiltration on any sequence.

Ddx: Pigmented villonodular synovitis Synovial sarcoma Lipoma Arborescens Synovial chrondromatosis Hypertrophic synovitis

Dxhow: Tissue biopsy

Exam: Physical exam revealed decreased range of motion in the left knee greater on flexion & a moderate effusion without erythema or warmth. There was a tender mass palpable at the anterior medial and lateral joint lines. Arthrocentesis of the joint revealed gross blood but fluid analysis proved otherwise unremarkable. Erythrocyte sedimentation rate, c-reactive protein, prothrombin time, & activated partial thromboplastin time were all within normal limits.

No MeSH data available.