Bilateral Localized Pigmented Villonodular Synovitis of the Knee: Case Report and Review

Fernandes, Tiago Lazzaretti; Videira, Livia Dau; Sasaki, Sandra Umeda; Natalino, Renato José Mendonça; Almeida, Arací Malagodi de; Pedrinelli, André; Hernandez, Arnaldo José

doi:10.1590/1413-785220182603179623

Cited by 4 publications

(2 citation statements)

References 11 publications

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“…The two categories of PVNS are the diffuse type and localized type, the latter accounting for 6% of cases [ 3 ]. Thus far, six cases of bilateral PVNS have been reported – only one of these cases was of the localized type, to our best knowledge [ 5 , 6 , 7 , 8 ]. In that case, the pain was localized to the suprapatellar sac bilaterally; symptoms occurred first in the right knee and then in the left knee 4 years later [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

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Localized Pigmented Villonodular Synovitis of the Bilateral Knee: A Case Report

Okamura¹,

Ishikawa²,

Ohno³

et al. 2022

JOCR

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Introduction: Localized pigmented villonodular synovitis (PVNS) is a rare and benign condition of synovial tissue proliferation that affects the joints, tendon sheaths, and bursae. This case report is the first to describe a patient with a diagnosis of localized PVNS of the knee after presentation with bilateral and simultaneous onset of associated knee pain. Case Report: A 28-year-old Japanese woman presented to our hospital with a 1-year history of bilateral knee pain and right knee locking that started 1 month ago. Magnetic resonance imaging demonstrated a mass lesion in both the anterior compartment of the right knee and in the posterior compartments of the left knee. Arthroscopic resection of the lesions was performed, and the diagnosis of localized PVNS was made by pathological analysis. At the 6-month follow-up, no evidence of recurrence was noted. Conclusion: This case report describes localized PVNS of the bilateral knee, which is extremely rare. PVNS is a disease requiring surgical resection and should not be overlooked. It should be treated with the possibility of bilateral occurrence in mind.

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Section: Discussionmentioning

confidence: 99%

“…The incidence of PVNS is 1.8 cases in 1 million; the localized type accounts for 6% of all cases [ 2 ]. To date, six cases of bilateral PVNS have been reported, and one of these cases was the localized type, which is extremely rare [ 5 , 6 , 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

Localized Pigmented Villonodular Synovitis of the Bilateral Knee: A Case Report

Okamura¹,

Ishikawa²,

Ohno³

et al. 2022

JOCR

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An unusual case report of tenosynovial giant cell tumor after unicompartmental knee arthroplasty presenting with recurrent hemarthrosis

Akatsuka

Matsumoto

Ogawa

et al. 2023

Journal of Orthopaedic Science

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Possibilities of ultrasonography in the diagnosis of pigmented villonodular synovitis. Clinical case

Zhdan,

Ivanytskyi,

Babanina

et al. 2023

Med. perspekt.

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Pigmented villonodular synovitis is a rare proliferative disease of the synovial membrane, which most often affects the knee joints. Being a benign disease, at the same time, this pathology is often aggressive, and in some cases spreads to the soft tissues outside the joint. There are two forms of monoarticular damage: localized and diffuse. The diffuse form gives frequent relapses. To date, there are no standards for the management of this disease, just as there are no early markers for the detection of pigmented villonodular synovitis. This joint lesion has a long asymptomatic course, or it has symptoms of non-specific recurrent arthritis, so the patients can later be referred for magnetic resonance imaging, which is the only non-invasive method of diagnosing this pathology. At the same time, in modern conditions, most patients with recurrent synovitis will undergo an ultrasound examination of the joint according to the diagnostic standards. Ultrasonography made for abovementioned synovitis is insufficiently described in the medical literature. The aim of our study was to highlight the current data on the diagnosis and management of patients with pigmented villonodular synovitis and to describe our own clinical case. A feature of our clinical case was the detection of characteristic symptoms using ultrasonography. Irregular thickening of the synovial membrane with nodular formations and villous growths, with the length of villi up to 7 mm near the patella with single loci of blood flow, was revealed by ultrasound examination and power Doppler mapping. Shear wave elastometry of the synovial membrane was performed. It demonstrated a significant increase in the stiffness of the synovial membrane, which can be a pathognomonic symptom of this pathology. The diagnosis of villonodular synovitis was confirmed histologically after surgical treatment. Subsequently, the patient had a recurrence of the pigmented villonodular synovitis, which was also detected by ultrasound diagnostics. Thus, pigmented villonodular synovitis of the knee joint is a rather rare pathology that requires differential diagnosis with inflammatory joint diseases. The final diagnosis is based on histological examination. MRI and ultrasound diagnostics are non-invasive methods that can detect this pathology with high accuracy. The advantage of ultrasonography is its availability and non-invasiveness. The increase in stiffness of the synovial membrane along with its proliferation, which we found, can serve as an additional criterion of villonodular synovitis, and, according to the data available to us, has not been described in the literature so far.

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Bilateral Localized Pigmented Villonodular Synovitis of the Knee: Case Report and Review

Cited by 4 publications

References 11 publications

Localized Pigmented Villonodular Synovitis of the Bilateral Knee: A Case Report

Localized Pigmented Villonodular Synovitis of the Bilateral Knee: A Case Report

An unusual case report of tenosynovial giant cell tumor after unicompartmental knee arthroplasty presenting with recurrent hemarthrosis

Possibilities of ultrasonography in the diagnosis of pigmented villonodular synovitis. Clinical case

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