Difuse pigmented villonodular sinovytis

Abstract

Introduction: pigmented villonodular synovitis is a benign synovial proliferation, associated with hemosiderin deposits, originating in the joints, bursas or tendon sheaths. The most affected joint is the knee, followed by the hip and, less frequently, shoulders, elbows and ankles. The imaging characteristics of this condition are very particular, which allows a good diagnostic approach through different radiological methods, particularly nuclear magnetic resonance.

Objective: to present a patient with pigmented villonodular synovitis, in whose diagnosis imaging methods were crucial, particularly nuclear magnetic resonance.

Case presentation: 41-year-old male patient with a health history. He presented a painful picture in the left knee joint, of two years of evolution, with volume increase and worsening of symptoms in the last two months. Ultrasound of the knee showed no imaging findings. The diagnosis was confirmed by nuclear magnetic resonance (with administration of intravenous contrast) and histopathological study.

Conclusions: before a patient with a suspected diagnosis of pigmented villonodular synovitis, imaging studies should be done to look for the typical findings of this disease. The use of nuclear magnetic resonance as a method of choice is crucial, because it allows to identify the specific imaging characteristics of the lesions (distinguishable from those corresponding to other synovial conditions) and its extension in soft tissues