Abstract:
Pigmented villonodular synovitis (PVNS) is an idiopathic villous overgrowth and pigmentation of the synovial membrane of a single joint. It is an uncommon condition characterized by yellow or yellowish-brown colour due to deposits of cholesterol and hemosiderin, excessive secretion of yellowish-brown synovial fluid, and the formation of brownish chocolate synovial tissue. This condition commonly occurs at the knee joint at the age of 20-50 years. Here we present a case of a 75-year-old male with PVNS involving the lower third of the right thigh who came to the surgery department and was eventually referred to the orthopedic department on the basis of investigations performed. It is a case of PVNS at a unique location on the lower third of the right thigh. The swelling was painless initially, but the pain increased over a duration of 10 months. Clinically, the mass was suspected to be bursitis or lipoma with features of mild inflammation in the overlying skin. Magnetic resonance imaging (MRI) suggested a swelling of 100*70*40 mm in dimension with the possibility of PVNS. Ultrasonography (USG) of the mass and fine needle aspiration cytology (FNAC) supported the diagnosis of PVNS. An excisional biopsy of the swelling was submitted. Per-operatively, there were typical features of PVNS. The swelling was situated superficial to the iliotibial band. There was no defect or gap in the iliotibial tract, and the swelling didn\'t have any continuity to the knee joint. The occurrence of synovial tissue without any attachment to the joint or tendon is rare and hence reported.
摘要:
色素沉着绒毛结节性滑膜炎(PVNS)是一种特发性绒毛过度生长和单关节滑膜色素沉着。这是一种罕见的疾病,其特征是由于胆固醇和含铁血黄素的沉积而呈黄色或黄棕色。黄褐色滑液分泌过多,并形成褐色巧克力滑膜组织。这种情况通常发生在20-50岁的膝关节。在这里,我们介绍了一例75岁的男性PVNS患者,涉及右大腿下三分之一,他来到外科,并根据所进行的调查最终被转诊到骨科。这是PVNS在右大腿下三分之一的独特位置的情况。最初肿胀是无痛的,但疼痛在10个月内加重。临床上,该肿块被怀疑是滑囊炎或脂肪瘤,其特征是上覆皮肤有轻度炎症。磁共振成像(MRI)提示肿胀的尺寸为100*70*40mm,可能存在PVNS。肿块的超声检查(USG)和细针穿刺细胞学检查(FNAC)支持PVNS的诊断。对肿胀进行了切除活检。根据操作,有典型的PVNS特征。肿胀位于胫骨带的浅层。髂胫束无缺损或间隙,肿胀对膝关节没有任何连续性。滑膜组织没有任何附着在关节或肌腱上的情况很少见,因此有报道。