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Atypical Presentation of Pigmented Villonodular Synovitis: A Case Report
Mohammed A AlDakhil1, Abdulaziz M AlDakhil1, Moyassar M Karami1
1Department of Orthopedic Surgery, King Khalid National Guard Hospital, Jeddah, Saudi Arabia.
Saudi Journal of Medicine & Medical Sciences
|February 22, 2019
Summary
Pigmented villonodular synovitis (PVNS) can present atypically in older adults, mimicking osteoarthritis. Early histopathological confirmation is crucial for accurate diagnosis, even with inconclusive imaging.
Area of Science:
- Orthopedics
- Rheumatology
- Pathology
Background:
- Pigmented villonodular synovitis (PVNS) is a rare, disabling joint disease typically affecting young adults.
- The condition often presents with non-specific symptoms, potentially delaying diagnosis.
Observation:
- A unique case of PVNS in a 60-year-old female is presented, diagnosed 20 years after initial knee pain symptoms.
- Radiological imaging, including MRI, showed only degenerative changes, failing to diagnose PVNS.
- Intraoperative findings of the synovium were suggestive of PVNS.
Findings:
- Histopathological examination confirmed pigmented villonodular synovitis.
- Diagnosis was significantly delayed due to initial presentation mimicking osteoarthritis and inconclusive imaging.
Implications:
- This case highlights the importance of considering PVNS in older patients with unexplained joint pain.
- Histopathological confirmation is recommended for suspected PVNS, irrespective of radiological findings.
- Timely diagnosis of PVNS is essential for appropriate management and to prevent disease progression.
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