Fact-sheet: Pigmented villonodular synovitis
  • Diffuse-type tenosynovial giant cell tumor


Updated on 08/26/2020 at 3:59 PM

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Definition

Benign proliferative disease arising from the joint synovium, bursa, or tendon sheath, belonging to the family of tenosynovial giant cell tumors.

Preferential involvement of the knees.

Clinical features

  • Knee pain
  • Long asymptomatic course

Radiography

  • Often normal
  • Nonspecific joint effusion
  • Soft tissue swelling
  • Adjacent bone erosion with periosteal reaction

Ultrasound

  • Cystic forms (anechoic lesion)
  • Synovial thickening
  • Complex heterogeneous echogenic masses and bone erosions

MRI

Reference examination:

  • T1: hyperintense foci
  • T2: hypointense foci
  • T2*: blooming effect: the hemosiderin foci appear more "conspicuous," best sought at the periphery
  • After injection: marked synovial enhancement

Management

Multidisciplinary management:
surgery, radiation therapy, brachytherapy, and radiosynoviorthesis are possible options.

Differential diagnosis

  • Lipoma arborescens
  • Aneurysmal bone cyst
  • Popliteal cyst