| Images of Musculoskeletal Oncology |
| Pigmented Villonodular Synovitis |
| A 28 year old female has had intermittent left hip pain for several years. Her pain became more frequent and more severe a few months ago. On exam she had a mild limp, pain and limitation of motion of the hip. |
| The AP and lateral radiographs demonstrate what appears to be a subchondial acetabular cyst. |
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| The MRI's demonstrate synovial thickening in the hip joint. The femoral head is alive. |
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| The histosections obtained from core needle biopsy demonstrate thickening of the synovium, with prominence of multi nuclear giant cells and a scattering of pigmentation. |
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| The post op x-ray demonstrates Stryker tricalcium phosphate that was placed in the subchondral cyst. The two screws in the greater trochanter were inserted during closure of the hip joint. Bone involvement on either side of the joint is common with PVNS. |
| The diagnosis of pigmented villonodular synovitis of the hip was made, and an attempt was made to perform a generous synovectomy. |
| Learning Issues: 1. Synovectomy is usually successful for symptomatic improvement, but does not guarantee a cure. |
| Images of Musculoskeletal Oncology |
| University at Buffalo Department of Orthopaedics |