Skip to main content
Log in

Intraarticular adalimumab in a patient with pigmented villonodular synovitis

  • Case Report
  • Published:
Rheumatology International Aims and scope Submit manuscript

Abstract

Pigmented villonodular synovitis is a chronic inflammatory disease progressing with histological villonodular hyperplasia in synovium, fibrosis and accumulation of hemosiderin. Knee joint is frequently involved leading to severe joint damage and disability in untreated cases. Treatment options include surgical intervention or radio-synovectomy with intraarticular yttrium-90. The case presented here includes significant clinical and radiological disease regression after intraarticular adalimumab in a patient diagnosed with radiologically and histologically confirmed pigmented villonodular synovitis who did not consent to surgical intervention.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

References

  1. Ofluoglu O (2006) Pigmented villonodular synovitis. Orthop Clin North Am 37:3–33

    Article  Google Scholar 

  2. Byers PD, Cotton RE, Deacon OW, Lowy M, Newman PH, Sissons HA et al (1968) The diagnosis and treatment of pigmented villonodular synovitis. J Bone Jt Surg Br 50:290–305

    CAS  Google Scholar 

  3. Akgun I, Ogut T, Kesmezacar H, Dervisoglu S (2003) Localized pigmented villonodular synovitis of the knee. Orthopedics 26:1131–1135

    PubMed  Google Scholar 

  4. Flandry F, Hughston JC, McCann SB, Kurtz DM (1994) Diagnostic features of diffuse pigmented villonodular synovitis of the knee. Clin Orthop Relat Res 298:212–220

    PubMed  Google Scholar 

  5. Jaffe HL, Lichtenstein L, Sutro CJ (1941) Pigmented villonodularis synovitis: bursitis and tenosynovitis. Arch Pathol 31:731–765

    Google Scholar 

  6. Aigner T, Oehler S, Niedobitek HG, Fassbender G, Kirchner T (1998) Iron deposits, cell populations and proliferative activity in pigmented villonodular synovitis of the knee joint. Verh Dtsch Ges Pathol 82:327–331

    CAS  PubMed  Google Scholar 

  7. Neale SD, Kristelly R, Gundle R, Quinn JM, Athanasou NA (1997) Giant cells in pigmented villonodular synovitis express an osteoclast phenotype. J Clin Pathol 50:605–608

    Article  CAS  PubMed  Google Scholar 

  8. O’Keefe RJ, Rosier RN, Teot LA, Stewart JM, Hicks DG (1998) Cytokine and matrix metalloproteinase expression in pigmented villonodular synovitis may mediate bone and cartilage destruction. Iowa Orthop J 18:26–34

    PubMed  Google Scholar 

  9. Yoshida W, Uzuki M, Kurose A, Yoshida M, Nishida J, Shimamura T et al (2003) Cell characterization of mononuclear and giant cells constituting pigmented villonodular synovitis. Hum Pathol 34:65–73

    Article  PubMed  Google Scholar 

  10. Weinblatt ME, Kremer JM, Bankhurst AD, Bulpitt KJ, Fleischmann RM, Fox RI et al (1999) A trial of etanercept, a recombinant tumor necrosis factor receptor: Fc fusion protein, in patients with rheumatoid arthritis receiving methotrexate. N Engl J Med 340:253–259

    Article  CAS  PubMed  Google Scholar 

  11. Berger I, Weckauf H, Helmchen B, Ehemann V, Penzel R, Fink B et al (2005) Rheumatoid arthritis and pigmented villonodular synovitis: comparative analysis of cell polyploidy, cell cycle phases and expression of macrophage and fibroblast markers in proliferating synovial cells. Histopathology 46:490–497

    Article  CAS  PubMed  Google Scholar 

  12. Yudoh K, Matsuno H, Nezuka T, Kimura T (1999) Different mechanisms of synovial hyperplasia in rheumatoid arthritis and pigmented villonodular synovitis: the role of telomerase activity in synovial proliferation. Arthritis Rheum 42:669–677

    Article  CAS  PubMed  Google Scholar 

  13. Kroot EJ, Kraan MC, Smeets TJ, Maas M, Tak PP, Wouters JM (2005) Tumour necrosis factor alpha blockade in treatment resistant pigmented villonodular synovitis. Ann Rheum Dis 64:497–499

    Article  PubMed  Google Scholar 

  14. Fiocco U, Sfriso P, Oliviero F, Sovran F, Scagliori E, Pagnin E, Vezzù M, Cozzi L, Botsios C, Nardacchione N, Di Maggio A, Rubaltelli L, Giacometti C, Calabrese F, Todesco S (2006) Intra-articular etanercept treatment for severe diffuse pigmented villonodular knee synovitis. Reumatismo 58(4):268–274

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Senol Kobak.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kobak, S. Intraarticular adalimumab in a patient with pigmented villonodular synovitis. Rheumatol Int 31, 251–254 (2011). https://doi.org/10.1007/s00296-009-1185-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00296-009-1185-z

Keywords

Navigation