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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.


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Pigmented villonodular synovitis

Cirivello MJC - MedPix (2007)

© Copyright Policy - open-access
Related In: Results  -  Collection

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

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.