Goldman A B, DiCarlo E F
Cornell University Medical College, New York, New York.
Radiol Clin North Am. 1988 Nov;26(6):1327-47.
PVNS is a proliferative disorder that can affect joints, tendons and bursae. Its etiology is unknown. The most widely accepted theories attribute this disorder to a chronic inflammatory response or a benign neoplasm of fibrohistiocytic origin. On gross specimens, the synovial changes are characterized by villous and/or nodular hyperplasia. This disorder occurs most frequently in the third or fourth decades of life and has no sex predilection. As a joint problem, it favors the knee and hip. As a tendon abnormality, it favors the digits. Plain film findings include 1) soft tissue swelling, 2) increased density of the synovium secondary to hemosiderin deposition, 3) multiple subchondral cysts, and 4) extrinsic cortical pressure erosions. Cartilage space narrowing, if present, is gradual and occurs later than the other plain film findings. Arthrography can demonstrate the nodular synovial changes and determine if the process is diffuse or focal. MRI can, in some cases, reveal areas of decreased signal within the hyperplastic synovium reflecting the deposition of hemosiderin. The major roentgen differential diagnoses of articular PVNS include uncalcified synovial chondromatosis, tuberculous arthritis, and hemophilic arthropathy.
色素沉着绒毛结节性滑膜炎（PVNS）是一种可累及关节、肌腱和滑囊的增殖性疾病。其病因不明。最被广泛接受的理论认为这种疾病是由慢性炎症反应或纤维组织细胞来源的良性肿瘤引起的。在大体标本上，滑膜改变的特征是绒毛状和/或结节状增生。这种疾病最常发生在生命的第三个或第四个十年，无性别倾向。作为一种关节问题，它好发于膝关节和髋关节。作为一种肌腱异常，它好发于手指。X线平片表现包括：1）软组织肿胀；2）由于含铁血黄素沉积导致滑膜密度增加；3）多个软骨下囊肿；4）外部皮质压迫性侵蚀。如果存在软骨间隙变窄，则是逐渐发生的，且比其他X线平片表现出现得晚。关节造影可显示结节状滑膜改变，并确定病变是弥漫性还是局灶性。在某些情况下，磁共振成像（MRI）可显示增生滑膜内信号减低区域，提示含铁血黄素沉积。关节型PVNS的主要X线鉴别诊断包括未钙化的滑膜软骨瘤病、结核性关节炎和血友病性关节病。
