Abstract
Pigmented villonodular synovitis (PVNS) can recur after complete synovectomy and even after total joint replacement. In the authors’ experience, there is a misconception that MRI may not be useful to diagnose PVNS in the setting of a total joint replacement due to dephasing artifact from metal. While there are case reports of PVNS in patients with total joint replacement diagnosed surgically, to our knowledge, diagnosis of recurrent PVNS by MRI following total joint replacement has not been reported. This report illustrates the utility of MRI in the diagnosis of recurrent PVNS following total joint replacement by reviewing two cases of pathologically correlated PVNS recurrence following arthroplasty, and two cases in which PVNS recurrence is strongly suspected, though pathological correlation is not available.
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Al-Nakshabandi, N. A.; Ryan, A. G.; Choudur, H.; Torreggiani, W.; Nicoloau, S.; Munk, P.L. E-mail: plmunk@interchange.ubc.ca; Al-Ismail, K. Pigmented villonodular synovitis. Clin Radiol. 2004 May;59(5):414–20.
Bitar, R, Leung, G, Perng, R, Tadros, S, Moody, A,R, Sarrazin, J, McGregor, C, Christakis, M, Symons, S, Nelson, A, Roberts TP. Radiographics. 2006; 26:513–537
Chung BJ, Park YB. Pigmented villonodular synovitis after TKA associated with tibial component loosening. Orthopedics. 2011 Aug 8;34(8):e418–20.
Cooper J.H., Ranawat A.S., Potter H.G., Foo L.F., Koob T.W., Ranawat C.S. Eary reactive synovitis and osteolysis after total hip arthorplasty. Clin Orthop Relat Res. 2010 Dec;468(12):3278–85.
Granowitz SP, D. J. (1976). The pathogenesis and long-term end results of pigmented villonodular synovitis. Clin Orthop Relat Res, 114: 335–351.
Fabbri N, Rustemi E, Masetti C, Kreshak J, Gambarotti M, Vanel D, Toni A, Mercuri M. Severe osteolysis and soft tissue mass around total hip arthroplasty: description of four cases and review of the literature with respect to clinico-radiographic and pathologic differential diagnosis. Eur J Radiol. 2011 Jan;77(1):43–50.
Hayter CL, Koff MF, Shah P, Koch KM, Miller TT, Potter HG. MRI after arthroplasty: comparison of MAVRIC and conventional fast spin-echo techniques. AJR Am J Roentgenol. 2011 Sep;197(3):W405–11.
Koch KM, Brau AC, Chen W, Gold GE, Hargreaves BA, Koff M, McKinnon GC, Potter HG, King KF. Imaging near metal with a MAVRIC-SEMAC hybrid. Magn Reson Med. 2011 Jan;65(1):71–82.
Ma X, Xia C, Wang L, Zhao L, Liu H, He J. An unusual case of pigmented villonodular synovitis 14 years after total hip arthroplasty. J Arthroplasty. 2011 Feb;26(2):339.e5–6
Mendenhall WM, Mendenhall CM, Reith JD, Scarborough MT, Gibbs CP, Mendenhall NP. Pigmented villonodular synovitis Am J Clin Oncol. 2006 Dec;29(6):548–50.
Murphey MD, R. J.-S. (2008). From the archives of the AFIP: pigmented villonodular synovitis: radiologic-pathologic correlation. Radiographics, 28: 1493–1518.
Potter HG, Nestor BJ, Sofka CM, Ho ST, Peters LE, Salvati EA. Magnetic resonance imaging after total hip arthroplasty: evaluation of periprosthetic soft tissue.J Bone Joint Surg Am. 2004 Sep;86-A(9):1947–54.
Ottaviani S, Ayral X, Dougados M, Gossec L. Pigmented villonodular synovitis: a retrospective single-center study of 122 cases and review of the literature. Semin Arthritis Rheum. 2011 Jun;40(6):539–46
Yoo JJ, Kwon YS, Koo KH, Yoon KS, Min BW, Kim HJ Cementless total hip arthroplasty performed in patients with pigmented villonodular synovitis. J Arthroplasty. 2010 Jun;25(4):552–7
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Friedman, T., Chen, T. & Chang, A. MRI Diagnosis of Recurrent Pigmented Villonodular Synovitis Following Total Joint Arthroplasty. HSS Jrnl 9, 100–105 (2013). https://doi.org/10.1007/s11420-012-9283-y
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DOI: https://doi.org/10.1007/s11420-012-9283-y