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Related Experiment Videos

Pigmented villonodular synovitis: a disease in evolution.

Henda Bouali1, Eric J Deppert, Lawrence J Leventhal

  • 1Department of Rheumatology, The Graduate Hospital, Philadelphia, Pennsylvania, USA. boualih@musc.edu

The Journal of Rheumatology
|August 4, 2004
PubMed
Summary

Pigmented villonodular synovitis (PVNS) typically presents with brown joint fluid. This case study details a rare PVNS presentation in the knee with clear fluid, challenging initial diagnosis.

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Area of Science:

  • Orthopedics
  • Rheumatology
  • Pathology

Background:

  • Pigmented villonodular synovitis (PVNS) is a rare, benign neoplastic proliferation affecting the synovium.
  • It commonly involves joints, tendon sheaths, and bursas, often presenting with characteristic hemorrhagic or xanthochromic synovial fluid.

Observation:

  • This report details an unusual case of PVNS in the right knee.
  • The patient presented with an acute, painless, nontraumatic effusion with clear synovial fluid.
  • Initial magnetic resonance imaging (MRI) showed no evidence of hemosiderin, a common marker for PVNS.

Findings:

  • Diagnostic arthroscopy and arthrotomy revealed PVNS.
  • The case demonstrated a unique progression from localized to diffuse synovial involvement.

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  • The clear synovial fluid and lack of hemosiderin on MRI initially obscured the diagnosis.

    • Implications:

    • This case highlights the importance of considering PVNS even with atypical presentations, such as clear synovial fluid.
    • It underscores the need for thorough diagnostic evaluation, including arthroscopy, when clinical suspicion for PVNS remains despite non-specific initial findings.
    • Understanding the varied presentations of PVNS is crucial for timely diagnosis and appropriate management of this rare condition.