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Osteonecrosis of the femoral head associated with pigmented villonodular synovitis

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Abstract

A 23-year-old Japanese woman with no history of corticosteroid intake or alcohol abuse presented with a 10-month history of left hip pain without any antecedent trauma. An anteroposterior radiograph performed 10 months after the onset of pain showed slight joint space narrowing and bone erosions surrounded by sclerotic lesions in both the acetabular roof and femoral neck. Magnetic resonance images of the left hip showed a feature of osteonecrosis of the femoral head and a mass with villus proliferation extending from the posterior intertrochanteric area to the anteromedial aspect of the femoral neck. In addition, the left quadratus femoris muscle, which is generally located just above the nutrient vessels of the femoral head, was not detected. Based on these findings, the patient was diagnosed with osteonecrosis of the femoral head caused by impairment of the nutrient vessels from invasion of the pigmented villonodular synovitis. She underwent radical synovectomy of the left hip 16 months after the onset of pain, and her hip pain improved after the surgery.

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Acknowledgements

This work was partially supported by the Practical Research Project for Rare/Intractable Diseases from the Japan Agency for Medical Research and Development (AMED) and a grant-in-aid in Scientific Research (grant 16K10906) from the Japan Society for the Promotion of Science.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan

    Shoji Baba, Goro Motomura, Junichi Fukushi, Satoshi Ikemura, Kazuhiko Sonoda, Yusuke Kubo, Takeshi Utsunomiya, Hiroyuki Hatanaka & Yasuharu Nakashima

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  1. Shoji Baba
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  2. Goro Motomura
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  3. Junichi Fukushi
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  4. Satoshi Ikemura
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  5. Kazuhiko Sonoda
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  6. Yusuke Kubo
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  7. Takeshi Utsunomiya
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  8. Hiroyuki Hatanaka
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  9. Yasuharu Nakashima
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Correspondence to Goro Motomura.

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Baba, S., Motomura, G., Fukushi, J. et al. Osteonecrosis of the femoral head associated with pigmented villonodular synovitis. Rheumatol Int 37, 841–845 (2017). https://doi.org/10.1007/s00296-016-3624-y

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  • DOI: https://doi.org/10.1007/s00296-016-3624-y

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