Zadeh Catherina, Henrichsen Jacob, Fatemi Nastaran, Westermann Robert
Diagnostic Radiology Department, University of Iowa Hospital and Clinics, 200 Hawkins Dr, Iowa City, IA, 52242, USA.
Orthopedic Surgery Department, University of Iowa Hospital and Clinics, 200 Hawkins Dr, Iowa City, IA, 52242, USA.
Skeletal Radiol. 2023 Jul;52(7):1409-1413. doi: 10.1007/s00256-022-04227-x. Epub 2022 Dec 7.
This article discusses two rare cases of intra-labral pigmented villonodular synovitis (PVNS) of the hip. The hip joint represents the second most common location of pigmented villonodular synovitis, second to the knee [1]. The majority of hip PVNS cases either diffusely involve the synovium or are focal lesions within the joint. The lesions and synovium show foci of low signal intensity related to hemosiderin deposition, a finding that differentiates PVNS from other causes of synovial proliferation. Our case report presents two rare manifestations of PVNS lesions localized within the hip labrum. This presentation could easily be mistaken for a cyst by imaging modality. Despite the rarity of this condition, we highlight the importance of questioning the possibility of intra-labral PVNS, when patients have persistent hip pain not responding to therapy and atypical imaging findings. Highlighting this rare presentation is crucial for establishing the correct diagnosis, guiding treatment, and obtaining the best clinical outcome.
本文讨论了两例罕见的髋关节盂唇内色素沉着绒毛结节性滑膜炎(PVNS)病例。髋关节是色素沉着绒毛结节性滑膜炎的第二常见发病部位,仅次于膝关节[1]。大多数髋关节PVNS病例要么弥漫性累及滑膜,要么是关节内的局灶性病变。病变和滑膜显示出与含铁血黄素沉积相关的低信号灶,这一发现可将PVNS与其他滑膜增生原因区分开来。我们的病例报告展示了PVNS病变局限于髋关节盂唇内的两种罕见表现。通过影像学检查,这种表现很容易被误诊为囊肿。尽管这种情况罕见,但当患者持续存在髋关节疼痛且对治疗无反应并有非典型影像学表现时,我们强调怀疑盂唇内PVNS可能性的重要性。强调这种罕见表现对于确立正确诊断、指导治疗以及获得最佳临床结果至关重要。