Page 4

Imaging Findings

  • Large effusion
  • Normal bone density
  • Cartilage preserved until late in process
  • Erosion; occurs in 50%
  • Large, well-marginated subchondral cyst
  • Secondary degenerative changes late in process
    • Cartilage narrowing, osteophyte formation
  • Very rarely & late, may show dystrophic calcification
  • Synovial-based masses
    • May be solitary nodular mass
    • May thicken synovium throughout most of joint, with nodularity
    • May extend through capsular defects along juxta-articular ligaments
    • T1 MR: Low signal, homogeneous
    • T2 & other fluid sensitive sequences: Variably low signal & inhomogeneous
    • Gradient echo sequence: Blooming relating to presence of hemosiderin
    • Post-contrast imaging: Moderate to intense enhancement, with inhomogeneity
  • Resection with synovectomy
  • Incomplete resection has high recurrence rate
    • Overall recurrence of intraarticular PVNS: 20-50% (the higher rate related to incomplete synovectomy)
  • Arthroscopic synovectomy unlikely to have complete access to some lesions & open procedure required
  • Radiation synovectomy occasionally is used following recurrence
  • Refractory cases with severe osteoarthritis require arthroplasty or arthrodesis
Follow-up imaging

Our patient with total hip arthroplasty

< Previous                                                                                                 Next >

We welcome your feedback, please send questions and comments to Marcel Maya, MD