Abstract
Introduction: Pigmented villonodular synovitis is an uncommon, benign, proliferative, neoplastic process of the synovial membrane presumed to be of histiocytic origin and is likely to cause diagnostic dilemma. We present 4 cases with varied presentations in the form of increasing groin pain, inguinal mass, co-existing osteoarthritis which were subsequently confirmed to have PVNS.
Methods and results: Clinical records and imaging modalities of 4 patients with histologically confirmed Pigmented villonodular synovitis of the hip, accrued from Scottish Bone Tumour Registry between 1969 and 2000 were reviewed.
Discussion: PVNS of the hip is an important differential diagnosis when osteoarthritis is associated with atypical clinical picture or lytic lesions. Although it remains confined to the joint, soft tissue masses extending beyond the capsule in to retroperitoneum or anterior and posterior aspects of hip have been reported as shown here. Radiographs in early stages are normal or include a concentric joint space narrowing. MR is an important non-invasive modality for surgical planning and to define the size and extent of the lesion, recurrence, delineating between synovial proliferations and periarticular or intra-abdominal organs. The role of arthroscopy, both diagnostic and therapeutic, is rapidly emerging, although, it has its own limitations. A carefully performed total excision often prevents recurrence as can be seen in this series.
Correspondence should be addressed to Mr John Hodgkinson, BHS, c/o BOA, The Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE.
