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Pigmented villonodular synovitis: keys to early diagnosis
M A Bhimani1, J F Wenz, F J Frassica
1Johns Hopkins School of Medicine, Baltimore, MD, USA.
Clinical Orthopaedics and Related Research
|May 12, 2001
Summary
Pigmented villonodular synovitis (PVNS) is a challenging diagnosis. Early identification through clinical clues and MRI is key for managing this hip joint disorder.
Area of Science:
- Orthopedics
- Radiology
- Pathology
Background:
- Pigmented villonodular synovitis (PVNS) is a rare, benign neoplastic proliferation of the synovium.
- It presents diagnostic challenges due to vague symptoms and varied radiographic findings.
Observation:
- Patients are typically in their third or fourth decade with monoarticular hip complaints.
- Symptoms include deep, intermittent hip pain, decreased range of motion, and potential early erosions of the femur and acetabulum.
Findings:
- Magnetic resonance imaging (MRI) is the preferred diagnostic modality.
- Characteristic MRI findings include joint effusion, synovial proliferation, and hip bulging, with low signal intensity on T1- and T2-weighted images due to hemosiderin.
Implications:
- PVNS should be considered in the differential diagnosis of young adults with unexplained hip pain.
- Accurate diagnosis aids in timely and appropriate management of this proliferative synovial disorder.