Pigmented villonodular synovitis in pediatric population: review of literature and a case report

Karami, Mohsen; Soleimani, Mehryar; Shiari, Reza

doi:10.1186/s12969-018-0222-4

Cited by 20 publications

(37 citation statements)

References 37 publications

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“…Differential diagnosis of PVNS versus arthritis remains challenging [38,42,43]. The findings from our study highlighted the delay in diagnosis and, sometimes, misdiagnosis of PVNS.…”

Section: Discussionmentioning

confidence: 75%

Identification of Patient Needs and Preferences in Pigmented Villonodular Synovitis (PVNS) Using a Qualitative Online Bulletin Board Study

et al. 2020

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Introduction: Pigmented villonodular synovitis (PVNS), also known as giant-cell tumour of the tendon sheath (GCTT), is a rare, benign proliferative tumour affecting the inner lining of synovial joints and tendon sheets. Information on treatment needs of PVNS patients to inform drug development is currently scarce. We conducted an exploratory qualitative study with PVNS patients to generate insights into the objective and emotional aspects related to their medical journey and experiences of living with this disease. Methods: A 4-day study using an online bulletin board (OBB), an asynchronous, online qualitative research platform, was conducted with patients recruited via physician referral who underwent screening questions to ensure eligibility for the study and willingness to participate. The discussion was moderated, was structured and allowed open answers in response to other participants' posts. Results: Eleven patients (4 from the USA, 4 from the UK and 3 from Canada; 45% female), aged 28-57 years, suffering from PVNS for 2-27 years participated in the study. Key patient insights from the study were: (1) pain was the topmost, spontaneous thought that the participants associated with PVNS, constituting a significant emotional and psychological burden; (2) surgery (arthroscopy) did not completely ameliorate symptoms associated with PVNS, as the relapse rate was high in these patients; (3) PVNS has a substantial negative financial impact on patients, their families and the healthcare system; (4) orthopaedic specialists/surgeons predominantly managed PVNS, as surgery is currently the only therapeutic option. Conclusion: PVNS patients expressed an urgent need for a medical drug treatment, which can reduce pain, avoid relapses and provide an alternative to surgery, the current standard of care.

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“…Differential diagnosis of PVNS versus arthritis remains challenging [38,42,43]. The findings from our study highlighted the delay in diagnosis and, sometimes, misdiagnosis of PVNS.…”

Section: Discussionmentioning

confidence: 75%

Identification of Patient Needs and Preferences in Pigmented Villonodular Synovitis (PVNS) Using a Qualitative Online Bulletin Board Study

et al. 2020

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“…Only five patients presented with the hip as the affected joint, and of those only one patient experienced acute symptoms of pain and inability to bear weight raising concern for infection and resulting in diagnosis through operative investigation [ 2 ]. While the average age of diagnosis is historically in the second to third decade of life, there have been reports of presentation as young as one year of age [ 7 ]. At time of presentation, the differential diagnosis focused on delineating acute infectious processes (osteomyelitis, septic joint, inguinal abscess) from musculoskeletal ones (ruptured hip ligament, avascular necrosis of the hip, bursitis vs synovitis due to trauma).…”

Section: Discussionmentioning

confidence: 99%

Pigmented Villonodular Synovitis Mimicking an Acute Septic Hip in an Eight-Year-Old Male

Marshall

Molina

Reiff

et al. 2020

Cureus

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Pigmented villonodular synovitis (PVNS) is a less common but known cause of joint pain in the adult population. PVNS in pediatric patients is even more rare, with only case reports of occurrence in persons under the age of 18 years. Presentation is typically that of more insidious pain and limited range of motion, and is primarily seen in the knee joint. Diagnosis can be suspected with imaging, but ultimately surgical intervention is needed for tissue confirmation. We present a case of PVNS in a pediatric patient with acute symptoms concerning for a septic joint. The patient’s workup revealed a large effusion on hip ultrasound, with operative intervention pursued and further imaging deferred given the patient's symptom burden. A 4 × 1 × 1.5 cm intra-articular pigmented mass excised from the synovium in the operating room. The patient’s symptoms improved after the procedure, with pathology showing sheets of plump mononuclear cells in a collagenized stroma with hemosiderin deposits, confirming the diagnosis. This case highlights the importance of keeping non-infectious etiologies in the differential diagnosis of acute onset joint pain.

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“…The classical presentation of this condition is monoarticular chronic joint effusion but multiple joints involvements have been also reported 1 . Thus, it could mimic other conditions with similar initial presentation, such as juvenile rheumatoid arthritis or septic arthritis 1 - 4 .…”

Section: Introductionmentioning

confidence: 99%

“…Although it is a benign lesion, the recommended management of PVNS in paediatric age group patients is open or arthroscopic synovectomy 4 . However, surgery can lead to complications such as secondary osteoarthritis, joint instability, joint stiffness and risk of growth plate damage in skeletally immature patients.…”

Section: Introductionmentioning

confidence: 99%

“…However, surgery can lead to complications such as secondary osteoarthritis, joint instability, joint stiffness and risk of growth plate damage in skeletally immature patients. Furthermore, radiotherapy is also not advisable for paediatric patients to avoid malignant transformation and risk of growth plate injury 4 . We report a paediatric case of knee PVNS, diagnosed and managed as septic arthritis before it turned out to be a PVNS that recovered well without synovectomy.…”

Section: Introductionmentioning

confidence: 99%

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Pigmented Villonodular Synovitis (PVNS) of the Knee mimicking Septic Arthritis in a Paediatric Patient: A Case Report

Indra¹,

IM²,

Vick-Duin³

et al. 2021

Malays Orthop J

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Pigmented villonodular synovitis (PVNS) is a benign but rare proliferative disorder of the synovium. It commonly occurs in the adult population and usually presents as a monoarticular disease. There are two types of PVNS, namely the localised and diffused type. The disease is often misdiagnosed due to its rarity especially in paediatric patients. Knee involvement in PVNS is the commonest form in children although other joints such as hip, foot, ankle, hip, sacroiliac joint and concurrent multiple joint involvements have also been reported. PVNS in paediatric patients is often misdiagnosed as septic arthritis, juvenile rheumatoid arthritis and bone sarcoma, and the diagnosis is usually often made late due to its vague presentation. The majority of PVNS cases are managed by surgery either via open or arthroscopic synovectomy except in a few paediatric patients as described in the literature. This case report of PVNS is of a knee in 11-year-old boy who was initially treated as septic arthritis. The synovium appearance mimicked the features of PVNS during a knee arthrotomy washout, and histopathological examination confirmed the diagnosis. The knee symptoms had significantly improved without additional surgery, and good functional knee motion was achieved, with no sign of recurrence, after two years of follow-up.

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Pigmented villonodular synovitis in pediatric population: review of literature and a case report

Cited by 20 publications

References 37 publications

Identification of Patient Needs and Preferences in Pigmented Villonodular Synovitis (PVNS) Using a Qualitative Online Bulletin Board Study

Identification of Patient Needs and Preferences in Pigmented Villonodular Synovitis (PVNS) Using a Qualitative Online Bulletin Board Study

Pigmented Villonodular Synovitis Mimicking an Acute Septic Hip in an Eight-Year-Old Male

Pigmented Villonodular Synovitis (PVNS) of the Knee mimicking Septic Arthritis in a Paediatric Patient: A Case Report

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