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Case Reports
. 2018 Oct 31;5(4):443-447.
doi: 10.1093/jhps/hny034. eCollection 2018 Dec.

Simultaneous pigmented villonodular synovitis and synovial chondromatosis of the hip: case report

Ben Efrima  1 , Nathan Safran  2 , Eyal Amar  3 , Ira Bachar Avnieli  4 , Yehuda Kollander  5 , Ehud Rath  3
Affiliations
Case Reports

Simultaneous pigmented villonodular synovitis and synovial chondromatosis of the hip: case report

Ben Efrima et al. J Hip Preserv Surg. .

Abstract

This report presents a case of a 37-year-old female with a history of hip pain. Magnetic resonance arthrography revealed loose bodies within the joint and synovial hypertrophy indicative of synovial chondromatosis (SC). Hip arthroscopy revealed free chondral bodies and focal villonodular synovial proliferation. The focal synovial proliferation was excised, a total synovectomy performed, and all cartilaginous free bodies removed. A post-operative histological examination of the removed nodular mass and synovium yielded evidence of both SC and pigmented villonodular synovitis (PVNS). A 1-year post-operative clinical examination showed marked clinical improvement and no signs of recurrence on MR images. Despite the clinical similarities, PVNS and SC are two distinct conditions that, to our knowledge, have never been reported as simultaneously occurring in a hip joint. The simultaneous presence of both pathologies may suggest a common origin of synovial metaplasia.

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Figures

Fig. 1.
Fig. 1.
(a) Preoperative MRI left hip. Free bodies present in the posterior joint space. An oval soft tissue mass occupies the space anterior to the femoral neck, edema seen at anterior femoral head as well as a labral tear. (b) Preoperative MRI. Free bodies present in the posterior joint space and in acetabular fossa. An oval soft tissue mass occupies the space anterior to the femoral neck.
Fig. 2.
Fig. 2.
An axial (frog) view of the left hip. The radiograph shows widening of the medial joint space and cam type FAI.
Fig. 3.
Fig. 3.
(a) Arthroscopic image. Numerous loose bodies can be seen in the peripheral joint. A needle is piercing the brownish-yellow soft tissue mass. (b) Arthroscopic image. Loose bodies are obstructing the acetabular fossa. (c) Arthroscopic image. A view of the oblong mass. A histological report revealed the mass as a PVNS nodule. (d) Arthroscopic image. Peripheral hip space after complete removal of free bodies, subtotal synovectomy and the removal of the PVNS lesion.
Fig. 4.
Fig. 4.
Post-operative MRI 1 year from surgery. There is no recurrence of free bodies or synovial proliferation is seen.
See this image and copyright information in PMC

References

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