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The locomotor system
Published in C. Simon Herrington, Muir's Textbook of Pathology, 2020
Diffuse pigmented villonodular synovitis most often involves the knee or hip joint, causing pain, blood-stained effusion, or locking of the joint. The synovium forms hyper-plastic pigmented villi, which become matted together to form solid nodular masses. The enlarged villi are covered by hyperplastic synovial cells and have numerous macrophages containing haemosiderin and lipid. The diffuse form of pigmented villonodular synovitis is more difficult to eradicate, and tends to recur. Bone may be eroded especially in cases involving the hip joint (Figure 13.39).
Arthroscopic hip preservation surgery
Published in K. Mohan Iyer, Hip Preservation Techniques, 2019
Pigmented villonodular synovitis presents as a focal or diffuse lesion. Both of these presentations can be addressed using arthroscopic excision. The prognosis is poorer in diffuse cases, with early progression to arthritis.
Temporomandibular Joint Disorders
Published in John C Watkinson, Raymond W Clarke, Terry M Jones, Vinidh Paleri, Nicholas White, Tim Woolford, Head & Neck Surgery Plastic Surgery, 2018
Neoplasms may be primary or secondary, benign or malignant. Primary benign neoplasms of the TMJ are rare and include chondroma, synovial chondromatosis, osteochondroma and osteoma. Malignant neoplasms are even more uncommon and the condyle seems to be preserved when the mandible is invaded by squamous carcinoma. Chondrosarcoma, osteochondrosarcoma and osteosarcoma are extremely rare in the head and neck and even more so in the condyle. They are dealt with elsewhere in this book. The slightly anomalous pigmented villonodular synovitis behaves as a neoplasm with locally invasive tendency, but again is rare.
Multiple subcutaneous xanthogranuloma at juxta-articular sites with bone cystic changes resembling rheumatoid arthritis: A case report
Published in Modern Rheumatology, 2018
Shoichi Kaneshiro, Kenrin Shi, Kosuke Ebina, Masao Yukioka, Hideki Yoshikawa, Norikazu Murata
From the appearance of multiple subcutaneous nodules at juxta-articular sites, the differential diagnoses should include rheumatoid nodules, multicentric reticulohistiocytosis and pigmented villonodular synovitis. Rheumatoid nodules are often bony hard [7], but the nodules in our case were all soft to elastic soft. Multicentric reticulohistiocytosis, often resembling and misdiagnosed as RA, manifests multiple joint destruction including distal interphalangeal joints [8]. Although the nodules mostly occurred near the joints in our case, joint destruction was not recognized either radiographically or intra-operatively. The lesions of this case had some similarities to pigmented villonodular synovitis, but neither did they locate in synovial-lined tissues, nor have hemosiderin deposition [9]. Finally, these differential diagnoses were all denied by histopathological findings.
Isolated proximal tibiofibular joint arthritis in a patient with juvenile idiopathic arthritis: A case report
Published in Modern Rheumatology, 2018
Hiroki Wakabayashi, Tomoki Nakamura, Akinobu Nishimura, Tomohito Hagi, Masahiro Hasegawa, Akihiro Sudo
A 14-year-old girl presented to her orthopedist with 6 months history of lateral right knee pain. There was no history of trauma and no family history of rheumatic diseases. Examination showed only tenderness over the right fibular head. The complete blood count, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) concentration were normal. Although her plain radiographs were normal, non-contrast-enhanced magnetic resonance imaging (MRI) showed a moderate PTF joint effusion with bony edema and surrounding synovial enhancement with synovial thickening. The T1-weighted image showed a relatively low-iso intense signal, and the T2-weighted image showed a relatively hyper-intense signal compared to skeletal muscle (Figure 1A–D). On MRI, a bone soft tissue tumor, especially pigmented villonodular synovitis (PVS), was suspected. A provisional diagnosis of a synovial cyst or PVS was made, and it was decided to do a biopsy. However, the patient refused the biopsy because her knee pain improved with NSAID treatment. Follow-up MRI performed 3 months later showed no remarkable changes. Therefore, the patient was followed as an outpatient with orthopedic evaluation, including plain radiographs and/or MRI, every year.
Whole-exome sequencing in three children with sporadic Blau syndrome, one of them co-presenting with recurrent polyserositis
Published in Autoimmunity, 2020
Carlos Córdova-Fletes, Martha M. Rangel-Sosa, Lizeth A. Martínez-Jacobo, Luis Eduardo Becerra-Solano, Carmen Araceli Arellano-Valdés, José Alberto Tlacuilo-Parra, Kame Alberto Galán-Huerta, Ana María Rivas-Estilla, Angélica Alejandra Hernandez-Orozco, José Elías García-Ortiz
Synovectomy demonstrated chronic unspecific synovitis, with no evidence of microorganisms. Arthrotomy was performed due to haemorrhage; findings included abundant hypertrophic intra-articular synovial tissue and medial and lateral chondral lesions with no complications. An ultrasound of the knees revealed diffuse villonodular synovitis with bursal effusion on the right knee. Later, an ipsilateral knee magnetic resonance image disclosed wide synovial collections, predominantly suprasellar, with thickness of bursas with heterogenic signal intensity not haemorrhagic.