Imaging Features of Pigmented Villonodular Synovitis with Emphasis on Sonographic Findings

J. Lin MD, W.J. Weadock, MD, T.J. Quinn MD, J.A. Jacobson MD, D.A. Jamadar MBBS, J.H. Ellis MD

University of Michigan, Ann Arbor Michigan

 

Case II: 30 year old female with PVNS of the left hip

Image D: AP radiograph of the pelvis shows large erosions (arrows) affecting the acetabulum and proximal right femur extending to the basicervical region. The joint space is narrowed axially.

Image E: Axial CT scan shows the erosions affecting both sides of the joint. The erosions have sclerotic margins. Soft tissue masses surround the joint. Core needle biopsy technique is demonstrated.

 

  • Erosions occur in up to 50% of cases of PVNS and are considered a pressure phenomenon, commonly occurring in tight joint capsules such as the hips and elbow.

  • Erosions in PVNS have sclerotic borders and are typically non-marginal.

  • When tissue diagnosis is required, CT guided biopsy provides a method for precise localization and sampling with low morbidity compared to surgical biopsy.