Pediatric Pigmented Villonodular Synovitis Mimicking a Septic Hip

Patel, Aarat M.; Brown, A. G. P.; Galambos, Csaba; Hirsch, Raphael

doi:10.1097/rhu.0b013e3181cf8657

Cited by 12 publications

(16 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Similar to the presentation of one of our patients is a case report of a 9-year-old child with an acute onset of hip pain that was treated 2 years prior to representation for presumed septic arthritis of the hip despite negative cultures. 20 MRI showed a large mass in the hip joint with blooming artifacts, and biopsy by interventional radiology was diagnostic of PVNS. At 1-year follow-up, the patient had complete resolution of symptoms with nonsteroidal anti-inflammatory medications and physical therapy, and the family elected to continue nonoperative treatment.…”

Section: Discussionmentioning

confidence: 97%

“…Although the knee has historically been described as the most common location of PVNS, pediatric case reports suggest that any joint can be involved. In addition to noting PVNS of the knee, 2,10,22 authors have described PVNS in the sacroiliac joint, 12 elbow, 24 hip, 9,20 and foot. 5 A more recent case report described a 7-year-old child with 2 years of hip pain and radiographs showing extensive bony erosive changes in the femoral head.…”

Section: Discussionmentioning

confidence: 99%

“…Literature describing PVNS in the pediatric population is limited to 2 small case series 1,19 and a handful of single-patient case reports. 5,9,10,12,20,22,24,26 Within these studies, only 2 patients with PVNS of the hip are described. 9,20 In addition, Byrd et al 3 described a case series of 13 patients (ranging in age from 14 to 46 years) with PVNS of the hip, but the majority of patients were adults.…”

mentioning

confidence: 99%

“…5,9,10,12,20,22,24,26 Within these studies, only 2 patients with PVNS of the hip are described. 9,20 In addition, Byrd et al 3 described a case series of 13 patients (ranging in age from 14 to 46 years) with PVNS of the hip, but the majority of patients were adults. The purpose of the current study was to describe the presentation, management, and outcomes of a single-center series of pediatric and adolescent patients with PVNS of the hip treated with arthroscopic synovectomy.…”

mentioning

confidence: 99%

See 3 more Smart Citations

Arthroscopic Management of Pigmented Villonodular Synovitis of the Hip in Children and Adolescents

Willimon

Schrader

Perkins

2018

Orthopaedic Journal of Sports Medicine

View full text Add to dashboard Cite

Background:Pigmented villonodular synovitis (PVNS) is a benign proliferative synovial disorder most commonly described to affect the knee in adults. Literature describing PVNS in the pediatric population is limited to 2 small case series and a handful of single-patient case reports. Within these studies, only 2 patients with PVNS of the hip are described.Purpose:To describe the presentation, management, and outcomes of a single-center series of pediatric patients with PVNS of the hip treated with arthroscopic synovectomy.Study Design:Case series; Level of evidence, 4.Methods:A retrospective review of consecutive pediatric patients treated for PVNS at a single institution was performed. Inclusion criteria consisted of patients younger than 19 years with surgically treated PVNS of the hip.Results:Five pediatric patients with a mean age of 11.0 years were treated for PVNS of the hip from 2011 to 2016. The mean duration of symptoms from onset to surgical treatment was 247 days (range, 3-933 days). Upon review of magnetic resonance imaging (MRI) results, radiologists included PVNS in their differential in 3 patients. Seven surgeries were performed in 5 patients. All therapeutic procedures were arthroscopic synovectomies. Nodular PVNS was present in 4 patients, and diffuse disease was present in 1 patient. At a mean 32-month follow-up (range, 12-63 months), all patients were considered to be free of recurrence based on clinical examination and/or follow-up MRI. Four patients were asymptomatic and returned to all of their previous sports activities.Conclusion:Young age at the time of diagnosis is a point to be highlighted in this cohort, and symptoms may be present for many months prior to diagnosis due to the failure to consider PVNS in children. Therefore, for patients with “atypical” presentations or lack of improvement with treatment for rheumatologic, bleeding, or infectious disorders, PVNS should be strongly considered. MRI with gradient echo sequences is the diagnostic imaging study of choice. One patient with diffuse involvement and preoperative degenerative changes showed progressive changes postoperatively. This type of PVNS may have a worse prognosis, but more diffuse cases are needed before the prognosis can be determined. Arthroscopic synovectomy following a timely diagnosis of PVNS produces good outcomes in nodular cases, with no evidence of symptomatic or radiographic disease persistence among these patients.

show abstract

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Arthroscopic Management of Pigmented Villonodular Synovitis of the Hip in Children and Adolescents

Willimon

Schrader

Perkins

2018

Orthopaedic Journal of Sports Medicine

View full text Add to dashboard Cite

show abstract

“…It is rarely considered in paediatric patient until multimodality of radiological investigations and tissue studies proved otherwise. The classical presentation of this condition is monoarticular chronic joint effusion but multiple joints involvements have been also reported 1 . Thus, it could mimic other conditions with similar initial presentation, such as juvenile rheumatoid arthritis or septic arthritis 1 - 4 .…”

Section: Introductionmentioning

confidence: 99%

Pigmented Villonodular Synovitis (PVNS) of the Knee mimicking Septic Arthritis in a Paediatric Patient: A Case Report

Indra¹,

IM²,

Vick-Duin³

et al. 2021

Malays Orthop J

View full text Add to dashboard Cite

Pigmented villonodular synovitis (PVNS) is a benign but rare proliferative disorder of the synovium. It commonly occurs in the adult population and usually presents as a monoarticular disease. There are two types of PVNS, namely the localised and diffused type. The disease is often misdiagnosed due to its rarity especially in paediatric patients. Knee involvement in PVNS is the commonest form in children although other joints such as hip, foot, ankle, hip, sacroiliac joint and concurrent multiple joint involvements have also been reported. PVNS in paediatric patients is often misdiagnosed as septic arthritis, juvenile rheumatoid arthritis and bone sarcoma, and the diagnosis is usually often made late due to its vague presentation. The majority of PVNS cases are managed by surgery either via open or arthroscopic synovectomy except in a few paediatric patients as described in the literature. This case report of PVNS is of a knee in 11-year-old boy who was initially treated as septic arthritis. The synovium appearance mimicked the features of PVNS during a knee arthrotomy washout, and histopathological examination confirmed the diagnosis. The knee symptoms had significantly improved without additional surgery, and good functional knee motion was achieved, with no sign of recurrence, after two years of follow-up.

show abstract

Surgical Technique: Arthroscopic Treatment of Pigmented Villonodular Synovitis

Willimon

Perkins

2021

Hip Arthroscopy and Hip Joint Preservation Surgery

View full text Add to dashboard Cite

Pediatric Pigmented Villonodular Synovitis Mimicking a Septic Hip

Cited by 12 publications

References 13 publications

Arthroscopic Management of Pigmented Villonodular Synovitis of the Hip in Children and Adolescents

Arthroscopic Management of Pigmented Villonodular Synovitis of the Hip in Children and Adolescents

Pigmented Villonodular Synovitis (PVNS) of the Knee mimicking Septic Arthritis in a Paediatric Patient: A Case Report

Surgical Technique: Arthroscopic Treatment of Pigmented Villonodular Synovitis

Contact Info

Product

Resources

About