Case report 578: Pigmented villonodular synovitis of the shoulder

An abrupt-onset shoulder joint subluxation and pseudoparalysis caused by intraarticular pigmented villonodular synovitis: A case report

Pigmented villonodular synovitis (PVNS) occurs most frequently in the knee and hand joints and is extremely rare in the shoulder joints. A 27-year-old women was admitted to our outpatient clinic with an abrupt-onset pain and limited range of motion of the left shoulder. On arthroscopic examination, localized PVNS surrounding the reactive synovitis in the posterior aspect of the subscapularis within the shoulder joint cavity. The mass was removed using a grasper and shaver. Symptomatic relief was achieved following surgical removal. In conclusion, although rare, localized PVNS of the shoulder joint should be kept in mind in patients with a sudden-onset shoulder joint subluxation and pseudoparalysis.

Subacromial bony erosion: a rare presentation of pigmented villonodular synovitis of the shoulder

Pigmented villonodular synovitis (PVNS) rarely affects the shoulder. We describe two cases of PVNS arising from the shoulder joint, which caused rotator cuff tears and sub-acromial bony erosion, and which were treated arthroscopically. Sub-acromial erosion is frequently associated with various glenohumeral joint disorders, but it has not been reported in association with PVNS. We believe PVNS should also be considered in the differential diagnosis of patients who present with sub-acromial erosion.

Arthroscopic treatment of pigmented villonodular synovitis of the shoulder

Pigmented villonodular synovitis (PVNS) rarely affects the shoulder. Fewer than 30 cases have been reported in the English and French language literature. In those patients, PVNS was treated by open surgery involving total or local synovectomy, sometimes associated with total shoulder replacement, cuff tear repair, or arthroplastic head resection. The authors report 2 cases of PVNS of the shoulder treated arthroscopically and discuss the advantages and limitations of this technique in the treatment of shoulder PVNS.

Pigmented villonodular synovitis: MRI characteristics

The magnetic resonance imaging (MRI) scans of 26 patients with histopathologically proven pigmented villonodular synovitis (PVNS), involving joints but excluding tendon sheaths, were reviewed retrospectively. The purpose of this study is to define the spectrum and frequency of MRI characteristics for PVNS using conventional spin echo (in two cases before and after intravenous administration of gadopentate dimeglumine) and also gradient echo techniques. A cystic variety is presented, the MRI appearances of which have not been found in a review of the literature.