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Pigmented villonodular synovitis. Diagnosis and differential diagnosis
1Cornell University Medical College, New York, New York.
Radiologic Clinics of North America
|November 1, 1988
Summary
Pigmented Villonodular Synovitis (PVNS) is a joint disorder with unknown causes, often affecting the knee and hip. Imaging like X-rays and MRI helps diagnose PVNS by revealing characteristic synovial changes and bone erosions.
Area of Science:
- Orthopedics
- Radiology
- Pathology
Background:
- Pigmented Villonodular Synovitis (PVNS) is a proliferative disorder affecting joints, tendons, and bursae.
- Its exact etiology remains unknown, with theories suggesting chronic inflammation or a benign fibrohistiocytic neoplasm.
- PVNS commonly affects individuals in their third or fourth decades, with a predilection for the knee and hip joints.
Purpose of the Study:
- To describe the clinical and imaging features of PVNS.
- To differentiate PVNS from other joint pathologies based on radiographic findings.
Main Methods:
- Review of plain film findings in PVNS.
- Discussion of arthrography and MRI characteristics.
- Comparison with differential diagnoses.
Main Results:
- Plain film findings include soft tissue swelling, increased synovium density (hemosiderin deposition), subchondral cysts, and cortical erosions.
- Cartilage space narrowing is a later finding.
- Arthrography and MRI can visualize synovial changes and hemosiderin deposition.
Conclusions:
- PVNS presents with characteristic radiographic features.
- Imaging modalities play a crucial role in diagnosing PVNS and guiding differential diagnoses.
- Key differential diagnoses include synovial chondromatosis, tuberculous arthritis, and hemophilic arthropathy.