A Case of Pigmented 
Villonodular Synovitis Misdiagnosed as Seronegative Rheumatoid Arthritis

Keimyung Medical Journal 2004;23(1):52-56.

A Case of Pigmented Villonodular Synovitis Misdiagnosed as Seronegative Rheumatoid Arthritis

혈청음성 류머티스관절염으로 오인된 색소성 융모결절윤활막염 1례

이상우; 임성택; 김종근; 김영조; 서준혁; 윤준철; 이찬우; 오동호; 이재욱; 문기혁; 백애란

Abstract

Pigmented villonodular synovitis is a uncommon benign proliferative disorder affecting the synovial membrane of joint; bursa and tendon sheath. The etiology is not apparent; however chronic inflammation and trauma may be the cause. The preferred lesions include joints of the lower extremity; especially the knee or hip; and commonly involves one joint. The presented case is a 23-year-old female with right knee pain and swelling for 2 years. Initially; she was diagnosed as seronegative rheumatoid arthritis. After medical treatment; however her symptom was not resolved. Arthrocentesis of her right knee showed bloody effusion; therefore we performed knee MRI arthroscopy for further evaluation. Knee MRI showed bursitis with synovial cysts; synovitis; joint effusion and bone erosion. On arthroscopy; yellowish-brown colored hypertrophied synovium was noted; and arthroscopic synovectomy was performed. Histologically; fibrous stroma; hemosiderin deposits; multinucleated giant cell and foam cells were found. Biopsy result was consistent with pigmented villonodular synovitis.

Key Words: Arthroscopic synovectomy, Pigmented villonodular synovitis