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[Pigmented villonodular synovitis. Diffuse and localized forms in children].

D Rosenberg1, R Kohler, E Chau

  • 1Département de pédiatrie, unité de rhumatologie pédiatrique, hôpital Edouard-Herriot, 5, place d'Arsonval, 69437 Lyon, France.

Archives De Pediatrie : Organe Officiel De La Societe Francaise De Pediatrie
|May 8, 2001
PubMed
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Pigmented villonodular synovitis (PVS) can cause joint destruction. Early diagnosis of PVS, aided by MRI and fluid aspiration, is crucial for effective surgical treatment.

Area of Science:

  • Orthopedics
  • Radiology
  • Pathology

Background:

  • Pigmented villonodular synovitis (PVS) is a rare, locally aggressive neoplastic proliferation of the synovium.
  • It can lead to progressive destruction of adjacent cartilage and bone, causing significant joint morbidity.

Observation:

  • Two pediatric cases of PVS are presented: a diffuse form in the knee and a localized form in the patellofemoral joint.
  • Clinical presentations included chronic arthritis and a palpable mass, with bloody synovial fluid noted in one case.

Findings:

  • MRI revealed heterogeneous synovial processes with signal abnormalities suggestive of hemosiderin deposition, characteristic of PVS.
  • Histological examination of biopsy and surgical specimens confirmed the diagnosis of PVS in both patients.

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Implications:

  • Delayed PVS diagnosis is common due to nonspecific symptoms.
  • Bloody synovial fluid aspiration and MRI are vital for early and accurate PVS diagnosis.
  • Surgical management, including extensive synovectomy for diffuse PVS and lesion excision for localized PVS, is the primary treatment modality.