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Magnetic resonance imaging in pigmented villonodular synovitis
S Eustace1, M Harrison, U Srinivasen
1Institute of Radiological Sciences, Mater Misericordiae Hospital, Dublin, Ireland.
Summary
Magnetic resonance imaging (MRI) aids in diagnosing pigmented villonodular synovitis (PVNS) of the knee by revealing hemosiderin deposits and synovial proliferation. MRI findings help guide biopsies for accurate diagnosis of this uncommon condition.
Area of Science:
- Orthopedics
- Radiology
- Medical Imaging
Background:
- Pigmented villonodular synovitis (PVNS) is an uncommon, benign neoplastic proliferation of the synovium.
- Accurate diagnosis is crucial for appropriate management and to differentiate from other intra-articular pathologies.
Observation:
- Three cases of knee PVNS are presented with their distinct magnetic resonance imaging (MRI) appearances.
- MRI demonstrated variable signal intensities, including low signal areas indicative of hemosiderin deposition in diffuse PVNS.
- Synovial proliferation was identified in both diffuse and localized forms of PVNS, with gadolinium enhancement aiding visualization in localized cases.
Findings:
- MRI effectively identifies key features of PVNS, such as hemosiderin deposits and synovial proliferation.
- The imaging characteristics vary depending on the form of PVNS (diffuse vs. localized) and the degree of hemosiderin deposition.
- MRI findings guided percutaneous and arthroscopic biopsies for definitive diagnosis.
Implications:
- MRI is a valuable non-invasive tool for diagnosing all forms of PVNS.
- Understanding MRI signal characteristics improves diagnostic accuracy and guides subsequent biopsy procedures.
- This imaging modality aids in the early and precise diagnosis of PVNS, optimizing patient treatment strategies.