Pigmented Villonodular synovitis (PVNS)
30 yr old young lady with non specific pain knee joint. MR shows well defined regular, intensely enhancing heterogenously altered signal intensity lesion anterior to hoffas pad with presence of haemosiderin and no bone involvement - focal variety of PVNS is likely. Case submitted by Dr MGK Murthy and Dr Akshay Sahoo.
Pigmented Villonodular synovitis (PVNS)
Teaching points
Definition: benign proliferative disease of the synovium affecting joints, bursae, and tendon sheaths(called giant cell tumour of tendons sheath)
Clinical: pain/ restricted movements
Types: diffuse-common(Shag carpet type or fern like proliferation of synovium) , and rarer focal nodular form(sessile or pedunculated with no true capsule), usually monoarticular, knee (80%) , focal -small joints of hands and feet (commonest soft tisue tumour of hand)
Xray---soft tissue swelling, no calcification, subchondral saucerised erosions
CT- hyperdense (haemosiderin), enhancement
MRI- Modality of choice--- soft tissue enhancing swelling , crossing joints with no involvement of articular margins, haemosiderin on gradient sequences, subtle bright on T1 due to lipid laden macrophages and fat, secondary degeneraive changes
Pigmented Villonodular synovitis (PVNS)
Teaching points
Definition: benign proliferative disease of the synovium affecting joints, bursae, and tendon sheaths(called giant cell tumour of tendons sheath)
Clinical: pain/ restricted movements
Types: diffuse-common(Shag carpet type or fern like proliferation of synovium) , and rarer focal nodular form(sessile or pedunculated with no true capsule), usually monoarticular, knee (80%) , focal -small joints of hands and feet (commonest soft tisue tumour of hand)
Xray---soft tissue swelling, no calcification, subchondral saucerised erosions
CT- hyperdense (haemosiderin), enhancement
MRI- Modality of choice--- soft tissue enhancing swelling , crossing joints with no involvement of articular margins, haemosiderin on gradient sequences, subtle bright on T1 due to lipid laden macrophages and fat, secondary degeneraive changes
Pigmented Villonodular synovitis (PVNS)
Reviewed by Sumer Sethi
on
Monday, November 29, 2010
Rating:
Reviewed by Sumer Sethi
on
Monday, November 29, 2010
Rating:
Sumer Sethi
Unique blend of academic excellence and entrepreneurship, heading leading firms in India- Teleradiology Providers, pioneering company providing teleradiology services and DAMS (Delhi Academy of Medical Sciences) Premier test preparation institute in India for MD/MS/MCI preparation. He has also been an invited faculty member at various conferences, including Teleradiology in IRIA 2008 and 2011, Hospital Build Middle East, Congress of the Brain Tumor Radiology in Neuro-oncology Society. Dr. Sethi is Editor-in-Chief of Internet Journal of Radiology. He has a keen interest in Web 2.0 technologies and in maintaining his famous radiology blog, which has been featured in multiple international journals.
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