Parikh Shital N, Chen Andrew L, Ergas Enrique
Department of Orthopaedics, Hospital for Joint Diseases, New York, New York 10003, USA.
Arthroscopy. 2002 Jul-Aug;18(6):E31. doi: 10.1053/jars.2002.31832.
Pigmented villonodular synovitis (PVNS) is a rare disorder that may involve the synovium of joints, bursa, or tendon sheaths. Monoarticular involvement is typical, with the knee most commonly affected. Localized pigmented villonodular synovitis (LPVNS) involves a discrete region of the synovium. Detection and diagnosis of this entity is clinically challenging, and plain radiographs are usually unremarkable. Magnetic resonance imaging (MRI) has been reported to be sensitive for the detection of synovial abnormalities and is the imaging modality of choice in suspected cases of LPVNS. When the diagnosis remains in doubt, arthroscopy may be used for direct visualization of synovial pathology, as well as to obtain tissue for histologic analysis. Definitive treatment may also be performed at the time of arthroscopy. We present a case of LPVNS in which a large (4 cm) lesion was not apparent on preoperative radiographs or MRI and was also missed on initial diagnostic arthroscopy.
色素沉着绒毛结节性滑膜炎（PVNS）是一种罕见疾病，可累及关节、滑囊或腱鞘的滑膜。单关节受累较为典型，其中膝关节最常受到影响。局限性色素沉着绒毛结节性滑膜炎（LPVNS）累及滑膜的一个离散区域。该疾病的检测和诊断在临床上具有挑战性，普通X线平片通常无明显异常。据报道，磁共振成像（MRI）对滑膜异常的检测很敏感，是疑似LPVNS病例的首选成像方式。当诊断仍存疑问时，关节镜检查可用于直接观察滑膜病变，以及获取组织进行组织学分析。在关节镜检查时也可进行确定性治疗。我们报告一例LPVNS病例，其中一个大的（4厘米）病变在术前X线平片或MRI上均未显示，在初次诊断性关节镜检查时也被漏诊。
