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Pigmented villonodular synovitis of thoracic facet joint presenting as rapidly progressive paraplegia

Leticia del Carmen Baena-Ocampo1, Luis M Rosales Olivares, Norma Marín Arriaga

  • 1Department of Pathology, Instituto Nacional de Rehabilitación, Mexico City, México.

Journal of Clinical Rheumatology : Practical Reports on Rheumatic & Musculoskeletal Diseases
|December 4, 2009
PubMed

Insights

Pigmented villonodular synovitis (PVNS) is a rare spinal condition. This case highlights PVNS in a thoracic facet joint causing myelopathy and paraplegia, emphasizing its potential for spinal cord compression.

Area of Science:

  • Rheumatology
  • Neurology
  • Orthopedic Surgery

Background:

  • Pigmented villonodular synovitis (PVNS) is a rare, benign neoplastic proliferation of the synovial membrane.
  • While commonly affecting appendicular joints, spinal involvement is infrequent.
  • The etiology of PVNS remains uncertain, contributing to diagnostic challenges.

Observation:

  • A young male presented with rapidly progressive myelopathy leading to paraplegia.
  • The cause was identified as PVNS originating from a thoracic facet joint.
  • This spinal PVNS led to significant spinal cord compression.

Findings:

  • Spinal PVNS, though rare, can manifest as a soft tissue mass in facet joints.
  • This mass can cause severe neurological deficits, including nerve root or spinal cord compression.
  • The case underscores the potential for PVNS to cause progressive myelopathy.

Implications:

  • PVNS should be considered in the differential diagnosis of spinal soft tissue masses, particularly those causing neurological compromise.
  • Early recognition and diagnosis of spinal PVNS are crucial for timely intervention and management.
  • Further research into the spinal manifestations of PVNS may improve patient outcomes.

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