Simmer Filho Jair, Ghidetti Thiago Henrique Cruz, Kautsky Raul Meyer
Serviço de Ortopedia e Traumatologia, Hospital Santa Rita de Cássia, Vitória, ES, Brasil.
Rev Bras Ortop (Sao Paulo). 2024 Apr 22;59(Suppl 2):e188-e193. doi: 10.1055/s-0044-1779313. eCollection 2024 Nov.
Pigmented villonodular synovitis (PVNS) is rare in the shoulder, with few descriptions in the literature. We present the case of a 58-year-old female patient with no history of trauma. The patient reported pain for 2 months with no limb irradiation and presented lifting strength loss and progressive limitation of active and passive mobility. She underwent unsupervised physical therapy and there was no improvement in symptoms. A magnetic resonance imaging (MRI) scan of the shoulder showed an oval structure of approximately 2 cm in diameter in the anteroinferior region of the glenohumeral joint with internal hypointense signal foci. We performed the arthroscopic treatment, with marginal resection of the lesion and tenotomy of the long bicipital head. The anatomopathological report confirmed the diagnosis of PVNS. Four years and five months after the surgery, the patient is pain-free, with full recovery of the left shoulder function. A follow-up MRI showed no recurrence, demonstrating the effectiveness of the arthroscopic treatment in this case.
色素沉着绒毛结节性滑膜炎（PVNS）在肩部较为罕见，文献中对此描述较少。我们报告一例58岁无外伤史的女性患者。患者自述疼痛2个月，无肢体放射性疼痛，伴有举力丧失以及主动和被动活动度逐渐受限。她接受了非监督性物理治疗，但症状并无改善。肩部磁共振成像（MRI）扫描显示，在盂肱关节前下区域有一个直径约2厘米的椭圆形结构，内部有低信号灶。我们进行了关节镜治疗，对病变进行边缘切除并切断肱二头肌长头。解剖病理学报告证实为PVNS。术后四年零五个月，患者无痛，左肩功能完全恢复。随访MRI显示无复发，证明了该病例中关节镜治疗的有效性。
