Case 1
Diagnosis

Diffuse form of pigmented villonodular synovitis
PVNS occurs predominantly in the early to middle age (2nd to 5th decades).
Presentation is usually with joint swelling, pain and occasionally joint dysfunction. Usually symptoms have been present for many months before diagnosis is made.
Malignant transformation of PVNS is rare, and controversy exists as to histologic criteria for its diagnosis.
Location:
Murphey MD, Rhee JH, Lewis RB, Fanburg-Smith JC, Flemming DJ, Walker EA. Pigmented Villonodular Synovitis: Radiologic-Pathologic Correlation. Radiographics 2008; 28(5):1493–1518
PVNS occurs predominantly in the early to middle age (2nd to 5th decades).
Presentation is usually with joint swelling, pain and occasionally joint dysfunction. Usually symptoms have been present for many months before diagnosis is made.
Malignant transformation of PVNS is rare, and controversy exists as to histologic criteria for its diagnosis.
Location:
- knee (far the most frequently affected joint 2): 66-80%
- hip: 4-16%
- ankle
- shoulder
- elbow
- spine
- other joints
- Localized - most common and usually extra-articular (PVNB and PVNTS).
- Diffuse - (i.e. involves all of the contiguous synovium) is the most common form of intra-articular disease, although local intra-articular is also sometimes seen.
- A giant cell tumours of the tendon sheath (GCTTS) is an uncommon and usually benign lesion that arises from the tendon sheath. It is unclear whether these lesions represent neoplasms or simply reactive masses.
Murphey MD, Rhee JH, Lewis RB, Fanburg-Smith JC, Flemming DJ, Walker EA. Pigmented Villonodular Synovitis: Radiologic-Pathologic Correlation. Radiographics 2008; 28(5):1493–1518