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Case Reports
. 2021 Apr 17;13(4):e14529.
doi: 10.7759/cureus.14529.

Pigmented Villonodular Synovitis of the Glenohumeral Joint and Biceps Tendon Sheath

Eli T Sayegh  1 , Richard M Wilk  1
Affiliations
Case Reports

Pigmented Villonodular Synovitis of the Glenohumeral Joint and Biceps Tendon Sheath

Eli T Sayegh et al. Cureus. .

Abstract

A 34-year-old woman presented with paroxysmal, insidious shoulder pain with effusion. MRI demonstrated a permeative, intermediate-signal lesion on T1 and T2 sequences involving the glenohumeral joint and biceps tendon sheath. The patient was treated with arthroscopic synovectomy, debridement, and subpectoral biceps tenodesis, with histopathology demonstrating pigmented villonodular synovitis (PVNS). PVNS is an extremely rare lesion of the glenohumeral joint and surrounding extra-articular structures. Awareness of this condition is paramount for timely diagnosis and intervention before joint destruction occurs. Arthroscopic treatment with meticulous attention to surgical technique is a feasible treatment strategy in the absence of end-stage chondral damage.

Keywords: arthroscopy; biceps tendon sheath; glenohumeral joint; pigmented villonodular synovitis; pvns; shoulder.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Sagittal proton-density fat-saturated MRI sequences demonstrating an intermediate-intensity, permeative, lobular lesion within the anterior glenohumeral (GH) compartment, axillary recess, and biceps tendon sheath.
Figure 2
Figure 2. Arthroscopic image of proliferative synovitis with numerous yellow-brown to rust-colored papillary projections situated within the left glenohumeral joint. Humeral head (left), glenoid and labrum (right), subscapularis (center), and biceps tendon (top) are depicted.
Figure 3
Figure 3. Arthroscopic image demonstrating disease removal following arthroscopic synovectomy and debridement of the left glenohumeral joint.
Figure 4
Figure 4. Low-power photomicrograph showing the villous architecture of proliferation, with villi composed of many mononuclear cells and few giant (multinucleate) cells, consistent with pigmented villonodular synovitis.
See this image and copyright information in PMC

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