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1.
Bull Hosp Jt Dis (2013) ; 82(3): 178-185, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-39150871

RESUMO

Diffuse-type giant cell tumor (Dt-GCT), formerly known as pigmented villonodular synovitis, is the more aggressive entity belonging to the spectrum of benign proliferative lesions of synovial origin that may affect the joints, bursae, and tendon sheaths. Diffuse-type giant cell tumor's importance stems from its local aggressiveness and sequelae if left untreated. This review briefly describes Dt-GCT's clinical features, its imaging and pathology findings, and provides an extensive discussion of its available treatments. The management approaches of Dt-GCT can be divided into surgical management and non-surgical management, which includes radiation therapy or more novel molecular and biologic therapies. We also present an algorithm based on disease presentation and site involved to guide treatment.


Assuntos
Tumor de Células Gigantes de Bainha Tendinosa , Sinovite Pigmentada Vilonodular , Humanos , Tumor de Células Gigantes de Bainha Tendinosa/terapia , Tumor de Células Gigantes de Bainha Tendinosa/cirurgia , Tumor de Células Gigantes de Bainha Tendinosa/diagnóstico por imagem , Tumor de Células Gigantes de Bainha Tendinosa/patologia , Sinovite Pigmentada Vilonodular/terapia , Sinovite Pigmentada Vilonodular/cirurgia , Sinovite Pigmentada Vilonodular/diagnóstico , Resultado do Tratamento , Algoritmos
3.
J Med Case Rep ; 18(1): 60, 2024 Feb 19.
Artigo em Inglês | MEDLINE | ID: mdl-38369524

RESUMO

BACKGROUND: Pigmented villonodular synovitis is a rare yet locally invasive disorder impacting synovial tissues. This case report delineates the atypical manifestation of pigmented villonodular synovitis in the talonavicular joint, detailing its diagnostic complexity and successful management. CASE PRESENTATION: A 56-year-old Iranian patient with a 4-year history of chronic ankle pain, initially diagnosed with degenerative joint disease post-trauma based on imaging, underwent talonavicular fusion surgery. An unexpected pigmented villonodular synovitis mass was encountered during the procedure. Subsequent interventions encompassed tumor resection, talonavicular joint fusion, and allograft bone grafting. Despite the initial intervention, persistent pain and nonunion necessitated a secondary procedure, involving joint surface curettage and autograft bone grafting. At the 12-month follow-up, the patient remained pain-free without tumor recurrence. CONCLUSION: This case report highlights the significance of considering pigmented villonodular synovitis as a crucial differential diagnosis in chronic ankle pain, even when there is evidence of degenerative joint disease and a history of trauma. Magnetic resonance imaging serves a crucial role in accurate diagnosis. Treatment necessitates precise tumor removal, appropriate bone grafting techniques and secure fixation. LEVEL OF EVIDENCE: IV.


Assuntos
Dor Crônica , Sinovite Pigmentada Vilonodular , Humanos , Pessoa de Meia-Idade , Sinovite Pigmentada Vilonodular/diagnóstico por imagem , Sinovite Pigmentada Vilonodular/cirurgia , Irã (Geográfico) , Recidiva Local de Neoplasia/complicações , Imageamento por Ressonância Magnética , Artralgia
4.
Eur J Surg Oncol ; 50(2): 107953, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38215550

RESUMO

BACKGROUND: Diffuse-type tenosynovial giant cell tumor (D-TGCT) is a mono-articular, soft-tissue tumor. Although it can behave locally aggressively, D-TGCT is a non-malignant disease. This is the first study describing the natural course of D-TGCT and evaluating active surveillance as possible treatment strategy. METHODS: This retrospective, multicenter study included therapy naïve patients with D-TGCT from eight sarcoma centers worldwide between 2000 and 2019. Patients initially managed by active surveillance following their first consultation were eligible. Data regarding the radiological and clinical course and subsequent treatments were collected. RESULTS: Sixty-one patients with primary D-TGCT were initially managed by active surveillance. Fifty-nine patients had an MRI performed around first consultation: D-TGCT was located intra-articular in most patients (n = 56; 95 %) and extra-articular in 14 cases (24 %). At baseline, osteoarthritis was observed in 13 patients (22 %) on MRI. Most of the patients' reported symptoms: pain (n = 43; 70 %), swelling (n = 33; 54 %). Eight patients (13 %) were asymptomatic. Follow-up data were available for 58 patients; the median follow-up was 28 months. Twenty-one patients (36 %) had radiological progression after 21 months (median). Eight of 45 patients (18 %) without osteoarthritis at baseline developed osteoarthritis during follow-up. Thirty-seven patients (64 %) did not clinically deteriorate during follow-up. Finally, eighteen patients (31 %) required a subsequent treatment. CONCLUSION: Active surveillance can be considered adequate for selected therapy naïve D-TGCT patients. Although follow-up data was limited, almost two-thirds of the patients remained progression-free, and 69 % did not need treatment during the follow-up period. However, one-fifth of patients developed secondary osteoarthritis. Prospective studies on active surveillance are warranted.


Assuntos
Tumor de Células Gigantes de Bainha Tendinosa , Osteoartrite , Neoplasias de Tecidos Moles , Sinovite Pigmentada Vilonodular , Humanos , Tumor de Células Gigantes de Bainha Tendinosa/terapia , Tumor de Células Gigantes de Bainha Tendinosa/tratamento farmacológico , Estudos Retrospectivos , Estudos Prospectivos , Conduta Expectante , Sinovite Pigmentada Vilonodular/patologia , Sinovite Pigmentada Vilonodular/cirurgia , Neoplasias de Tecidos Moles/terapia , Neoplasias de Tecidos Moles/cirurgia
5.
Clin Orthop Relat Res ; 482(7): 1218-1229, 2024 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-38153106

RESUMO

BACKGROUND: Diffuse-type tenosynovial giant-cell tumor (D-TGCT), formerly known as pigmented villonodular synovitis, is a rare, locally aggressive, invasive soft tissue tumor that primarily occurs in the knee. Surgical excision is the main treatment option, but there is a high recurrence rate. Arthroscopic surgical techniques are emphasized because they are less traumatic and offer faster postoperative recovery, but detailed reports on arthroscopic techniques and outcomes of D-TGCT in large cohorts are still lacking. QUESTIONS/PURPOSES: (1) What is the recurrence rate of knee D-TGCT after multiportal arthroscopic synovectomy? (2) What are the complications, knee ROM, pain score, and patient-reported outcomes for patients, and do they differ between patients with and without recurrence? (3) What factors are associated with recurrence after arthroscopic treatment in patients with D-TGCT? METHODS: In this single-center, retrospective study conducted between January 2010 and April 2021, we treated 295 patients with knee D-TGCTs. We considered patients undergoing initial surgical treatment with multiportal arthroscopic synovectomy as potentially eligible. Based on that, 27% (81 of 295) of patients were excluded because of recurrence after synovectomy performed at another institution. Of the 214 patients who met the inclusion criteria, 17% (36 of 214) were lost to follow-up, leaving 83% (178 of 214) of patients in the analysis. Twenty-eight percent (50 of 178) of patients were men and 72% (128 of 178) were women, with a median (range) age of 36 years (7 to 69). The median follow-up duration was 80 months (26 to 149). All patients underwent multiportal (anterior and posterior approaches) arthroscopic synovectomy, and all surgical protocols were determined by discussion among four surgeons after preoperative MRI. A combined open posterior incision was used for patients with lesions that invaded or surrounded the blood vessels and nerves or invaded the muscle space extraarticularly. Standard postoperative adjuvant radiotherapy was recommended for all patients with D-TGCT who had extraarticular and posterior compartment invasion; for patients with only anterior compartment invasion, radiotherapy was recommended for severe cases as assessed by the surgeons and radiologists based on preoperative MRI and intraoperative descriptions. Postoperative recurrence at 5 years was calculated using a Kaplan-Meier survivorship estimator. The WOMAC score (0 to 96, with higher scores representing a worse outcome; minimum clinically important difference [MCID] 8.5), the Lysholm knee score (0 to 100, with higher scores being better knee function; MCID 25.4), the VAS for pain (0 to 10, with higher scores representing more pain; MCID 2.46), and knee ROM were used to evaluate functional outcomes. Because we did not have preoperative patient-reported outcomes scores, we present data on the proportion of patients who achieved the patient-acceptable symptom state (PASS) for each of those outcome metrics, which were 14.6 of 96 points on the WOMAC, 52.5 of 100 points on the Lysholm, and 2.32 of 10 points on the VAS. RESULTS: The symptomatic or radiographically documented recurrence at 5 years was 12% (95% confidence interval [CI] 7% to 17%) using the Kaplan-Meier estimator, with a mean recurrence time of 33 ± 19 months. Of these, three were asymptomatic recurrences found during regular MRI reviews, and the remaining 19 underwent repeat surgery. There was one intraoperative complication (vascular injury) with no effect on postoperative limb function and eight patients with postoperative joint stiffness, seven of whom improved with prolonged rehabilitation and one with manipulation under anesthesia. No postradiotherapy complications were found. The proportion of patients who achieved the preestablished PASS was 99% (176 of 178) for the VAS pain score, 97% (173 of 178) for the WOMAC score, and 100% (178 of 178) for the Lysholm score. A lower percentage of patients with recurrence achieved the PASS for WOMAC score than patients without recurrence (86% [19] versus 99% [154], OR 0.08 [95% CI 0.01 to 0.52]; p = 0.01), whereas no difference was found in the percentage of VAS score (95% [21] versus 99% [155], OR 0.14 [95% CI 0.01 to 2.25]; p = 0.23) or Lysholm score (100% [22] versus 100% [156], OR 1 [95% CI 1 to 1]; p = 0.99). Moreover, patients in the recurrence group showed worse knee flexion (median 135° [100° to 135°] versus median 135° [80° to 135°]; difference of medians 0°; p = 0.03), worse WOMAC score (median 3.5 [0 to 19] versus median 1 [0 to 29]; difference of medians 2.5; p = 0.01), and higher VAS pain score (median 1 [0 to 4] versus median 0 [0 to 4]; difference of medians 1; p < 0.01) than those in the nonrecurrence group, although no differences reached the MCID. No factors were associated with D-TGCT recurrence, including the use of postoperative radiotherapy, surgical technique, and invasion extent. CONCLUSION: This single-center, large-cohort retrospective study confirmed that multiportal arthroscopic surgery can be used to treat knee D-TGCTs with a low recurrence rate, few complications, and satisfactory postoperative outcomes. Surgeons should conduct a thorough preoperative evaluation, meticulous arthroscopic synovectomy, and regular postoperative follow-up when treating patients with D-TGCT to reduce postoperative recurrence. Because the available evidence does not appear to fully support the use of postoperative adjuvant radiotherapy in all patients with D-TGCTs and our study design is inadequate to resolve this controversial issue, future studies should look for more appropriate indications for radiotherapy, such as planning based on a more precise classification of lesion invasion. LEVEL OF EVIDENCE: Level III, therapeutic study.


Assuntos
Artroscopia , Articulação do Joelho , Recidiva Local de Neoplasia , Sinovectomia , Humanos , Masculino , Feminino , Artroscopia/métodos , Artroscopia/efeitos adversos , Adulto , Pessoa de Meia-Idade , Estudos Retrospectivos , Articulação do Joelho/cirurgia , Articulação do Joelho/fisiopatologia , Articulação do Joelho/diagnóstico por imagem , Tumor de Células Gigantes de Bainha Tendinosa/cirurgia , Tumor de Células Gigantes de Bainha Tendinosa/fisiopatologia , Resultado do Tratamento , Complicações Pós-Operatórias/etiologia , Sinovite Pigmentada Vilonodular/cirurgia , Sinovite Pigmentada Vilonodular/fisiopatologia , Amplitude de Movimento Articular , Adulto Jovem , Idoso , Medidas de Resultados Relatados pelo Paciente , Recuperação de Função Fisiológica
6.
Hua Xi Kou Qiang Yi Xue Za Zhi ; 41(6): 725-730, 2023 Dec 01.
Artigo em Inglês, Chinês | MEDLINE | ID: mdl-38597040

RESUMO

Pigmented villonodular synovitis (PVNS) is a rare locally aggressive benign tumor in the temporomandibular joint (TMJ). This paper presents a patient with TMJ-PVNS involving masseteric space, temporal bone, zygomatic process, and mandibular ramus. Digital technique was used to determine the boundary of the lesion and reconstruct the normal glenoid fossa. The temporalis myofascial flap was transplanted between titanium mesh and condyle to reconstruct the disk after the complete resection of the tumor. The patient's facial profile is symmetrical, with a mouth ope-ning of 43 mm. No local recurrence and complications, such as cerebrospinal fluid fistula and encephaloceles, were detected during 30-month follow-up period.


Assuntos
Sinovite Pigmentada Vilonodular , Transtornos da Articulação Temporomandibular , Humanos , Sinovite Pigmentada Vilonodular/diagnóstico , Sinovite Pigmentada Vilonodular/cirurgia , Transtornos da Articulação Temporomandibular/diagnóstico , Transtornos da Articulação Temporomandibular/cirurgia , Articulação Temporomandibular/cirurgia , Articulação Temporomandibular/patologia , Diagnóstico Diferencial , Crânio/patologia
7.
Rev. cir. traumatol. buco-maxilo-fac ; 22(4): 20-29, out.-dez. 2022. ilus, tab
Artigo em Português | LILACS, BBO - Odontologia | ID: biblio-1414512

RESUMO

Objetivo: Avaliar os casos nos quais os pacientes apresentassem SVNP na ATM, incluindo aspectos clínicos, imaginológicos, histopatológicos e tratamento. Metodologia: Trata-se de uma revisão integrativa com dados obtidos nas bases de dados SciELO, PubMed, Medline e Lillacs entre 1982 e 2021, através dos descritores: "Case report", "Temporomandibular Joint", "Pigmented Villonodular Synovitis". Critérios de inclusão: estudos de relato de caso, textos completos disponíveis, idiomas de publicação em inglês, português ou espanhol. Critérios de exclusão: estudos sem presença de aspectos clínicos, relatos não localizados na ATM, artigos de metanálise, revisão sistemática e de literatura, ensaios clínicos, capítulos de livro, dissertações e teses. Dos 156 resultados, apenas 23 compuseram a revisão. Resultados: Como tratamento, a ressecção total através da cirurgia aberta é recomendada. Os sintomas mais comuns foram: dor na mastigação, trismo, dor pré auricular, dormência, parestesia, perca auditiva e inchaço da glândula parótida. Conclusão: Os aspectos imaginológicos revelam erosão de fossa glenóide e côndilo, histopatologicamente, células gigantes com depósito de hemossiderina, e o tratamento recomendado, ressecção via cirurgia aberta com posterior curetagem... (AU)


Objective: To evaluate the cases in which patients presented PVNS in the TMJ, including clinical, imaging, histopathological and treatment aspects. Methodology: This is an integrative review with data obtained from the SciELO, PubMed, Medline and Lillacs databases between 1982 and 2021, using the descriptors: "Case report", "Temporomandibular Joint", "Pigmented Villonodular Synovitis". Inclusion criteria: case report studies, full texts available, languages of publication in English, Portuguese or Spanish. Exclusion criteria: studies without the presence of clinical aspects, reports not located in the TMJ, meta analysis articles, systematic and literature reviews, clinical trials, book chapters, dissertations and theses. Of the 156 results, only 23 made up the review. Results: As a treatment, total resection through open surgery is recommended. The most common symptoms were: chewing pain, trismus, pre-auricular pain, numbness, paresthesia, hearing loss and parotid gland swelling. Conclusion: The imaging findings reveal erosion of the glenoid fossa and condyle, histopathologically, giant cells with hemosiderin deposits, and the recommended treatment, resection via open surgery with subsequent curettage... (AU)


Objetivo: Evaluar los casos en que los pacientes presentaron SVNP en la ATM, incluyendo aspectos clínicos, imagenológicos, histopatológicos y tratamiento. Metodología: Se trata de una revisión integradora con datos obtenidos de las bases de datos SciELO, PubMed, Medline y Lillacs entre 1982 y 2021, utilizando los descriptores: "Caso clínico", "Articulación temporomandibular", "Sinovitis villonodular pigmentada". Criterios de inclusión: estudios de casos clínicos, textos completos disponibles, idiomas de publicación en inglés, portugués o español. Criterios de exclusión: estudios sin aspectos clínicos, informes no localizados en la ATM, artículos de metanálisis, revisiones sistemáticas y de literatura, ensayos clínicos, capítulos de libros, disertaciones y tesis. De los 156 resultados, 23 conformaron la revisión. Resultados: Como tratamiento se recomienda la resección total mediante cirugía abierta. Los síntomas más frecuentes fueron: dolor masticatorio, trismus, dolor preauricular, entumecimiento, parestesia, hipoacusia e inflamación de glándula parótida. Conclusión: Los hallazgos imagenológicos revelan erosión de fosa glenoidea y cóndilo, histopatológicamente células gigantes con depósitos de hemosiderina y el tratamiento recomendado, resección abierta con posterior curetaje... (AU)


Assuntos
Humanos , Masculino , Feminino , Sinovite Pigmentada Vilonodular/cirurgia , Articulação Temporomandibular , Células Gigantes , Sinovite Pigmentada Vilonodular , Curetagem , Cavidade Glenoide
8.
Rev. chil. radiol ; 26(3): 117-119, set. 2020. ilus
Artigo em Espanhol | LILACS | ID: biblio-1138706

RESUMO

Resumen: La sinovitis villonodular pigmentada extraarticular, también llamada tumor de células gigantes de la vaina tendinosa, es frecuente en la mano, siendo extremadamente rara su localización en la rodilla. Se presenta el caso de un paciente con una bursitis villonodular pigmentada de la bursa de la pata de ganso sin afectación intraarticular. Extra-articular pigmented villonodular synovitis, also called giant cell tumor of the tendon sheath, is common in the hand, being extremely rare in the knee. We present the case of a patient with a pigmented villonodular bursitis of the pes anserine bursa without intraarticular involvement.


Abstract: Extra-articular pigmented villonodular synovitis, also called giant cell tumor of the tendon seath, is common in the hand, being extremely rare in the knee. We present the case of a patient with a pigmented villonodular bursitis of the pes anserine bursa without intraarticular involvement.


Assuntos
Humanos , Masculino , Adolescente , Sinovite Pigmentada Vilonodular/diagnóstico por imagem , Bursite/diagnóstico por imagem , Tumores de Células Gigantes/diagnóstico por imagem , Sinovite Pigmentada Vilonodular/cirurgia , Biópsia , Bursite/cirurgia , Espectroscopia de Ressonância Magnética , Tumores de Células Gigantes/cirurgia , Joelho/patologia
9.
Medwave ; 19(4): e7641, 2019.
Artigo em Inglês, Espanhol | LILACS | ID: biblio-998354

RESUMO

La sinovitis villonodular pigmentada es un tumor benigno del tejido sinovial de muy baja incidencia. El compromiso de tobillo es aún menos frecuente. Se requiere diagnóstico y manejo precoz para evitar secuelas funcionales y mecánicas irreversibles. Se manifiesta inicialmente con aumento de volumen de partes blandas, edema o derrame articular y puede evolucionar con dolor progresivo y daño articular avanzado. Existe una forma focal y una difusa, siendo esta última la de peor pronóstico. El examen diagnóstico de elección es la resonancia magnética, confirmándose por biopsia en la que se observa tejido sinovial inflamatorio con depósitos de hemosiderina. El tratamiento es quirúrgico y consiste en sinovectomía abierta o artroscópica. La recurrencia es de hasta un 40%, por lo que están descritas terapias coadyuvantes biológicas y radioterapia. Este artículo expone el caso de un hombre de 30 años que consulta por dolor y claudicación del tobillo izquierdo, encontrándose en el estudio imagenológico (resonancia magnética) hallazgos compatibles con sinovitis villonodular pigmentada difusa del tobillo, con extensión a la articulación subtalar, por lo que se realiza artroscopía para tratamiento y biopsia. En este reporte de caso se ilustran los resultados con este paciente y una revisión bibliográfica del tema.


Pigmented villonodular synovitis is a benign tumor of synovial tissue with a very low incidence. Ankle location is even less frequent. Early diagnosis and management are required to avoid irreversible functional and mechanical sequelae. The clinical presentation starts with edema or joint effusion and may progress with pain and advanced joint degenerative changes. Pigmented villonodular synovitis can be focal or diffuse, the latter being the type with the worst prognosis. When suspected, magnetic resonance imaging is performed, and the diagnosis confirmed with a biopsy in which synovial inflammatory tissue with hemosiderin deposits is observed. An open or arthroscopic synovectomy is preferred over surgical management. Recurrence is up to 40%, which is why biological coadjutant therapies and radiotherapy are described. This article presents the case of a 30-year-old man who presented with pain and claudication of the left ankle; the imaging study findings were compatible with diffuse pigmented villonodular synovitis of the ankle with extension to the subtalar joint, leading to arthroscopy for treatment and biopsy. This case report illustrates the results with this patient and a literature review of the subject.


Assuntos
Humanos , Masculino , Adulto , Artroscopia/métodos , Sinovite Pigmentada Vilonodular/cirurgia , Articulação do Tornozelo/cirurgia , Dor/etiologia , Sinovite Pigmentada Vilonodular/diagnóstico , Biópsia , Imageamento por Ressonância Magnética , Sinovectomia/métodos , Articulação do Tornozelo/patologia
10.
Acta ortop. mex ; 31(6): 308-311, nov.-dic. 2017. graf
Artigo em Espanhol | LILACS | ID: biblio-949786

RESUMO

Resumen: Introducción: La sinovitis villonodular pigmentada (SNVP) es una entidad clínica poco frecuente, con un incidencia mayor en las mujeres (3:1) y una edad de presentación entre los 20 y 40 años. La cadera es un sitio poco común de ocurrencia, estando involucrada en tan solo 15% de todos los casos. Reporte de caso: Masculino de 47 años con cuadro de 10 años de evolución caracterizado por limitación de los arcos de movilidad, dolor asociado a aumento de volumen y acortamiento del miembro pélvico; los estudios de imagen mostraron destrucción de la articulación coxofemoral y extensión a la pelvis; el reporte histopatológico describió sinovitis villonodular pigmentada. Fue manejado con hemipelvectomía externa izquierda. Discusión: La presentación de la sinovitis villonodular pigmentada difusa en la cadera tiene una incidencia baja y comportamiento localmente agresivo. Es necesario tener en cuenta diagnósticos diferenciales que incluyan neoplasias malignas. El estándar de tratamiento es quirúrgico.


Abstract: Introduction: Pigmented villonodular synovitis (PVNS) is a rare clinical entity with higher incidence in women (3:1) and an age of presentation between 20 and 40 years. The hip is a rare site of appearance, being involved in only 15% of all cases. Case report: 47-year-old male with 10 years of evolution characterized by a limited range of motion, pain associated with an increase in volume and shortening of the pelvic limb. Imaging studies showed destruction of the hip joint and extension to the pelvis. The histopathology report described pigmented villonodular synovitis. His final treatment was left hemipelvectomy. Discussion: The presentation of the diffuse pigmented villonodular synovitis of the hip has a lower incidence and a locally aggressive behavior. It is necessary to consider differential diagnoses that include malignant neoplasms. The standard treatment is surgical.


Assuntos
Humanos , Masculino , Feminino , Sinovite Pigmentada Vilonodular/cirurgia , Sinovite Pigmentada Vilonodular/complicações , Sinovite Pigmentada Vilonodular/diagnóstico , Dor/etiologia , Pelve/cirurgia , Diagnóstico Diferencial , Articulação do Quadril/cirurgia , Pessoa de Meia-Idade
11.
Rev. Esp. Cir. Ortop. Traumatol. (Ed. Impr.) ; 59(6): 400-405, nov.-dic. 2015. tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-145174

RESUMO

Introducción. La sinovitis villonodular pigmentaria (SVP) es un trastorno de la proliferación sinovial de etiología incierta, con un tratamiento controvertido. El objetivo del estudio es valorar los resultados funcionales y la tasa de recurrencia en una serie de pacientes diagnosticados de SVP de rodilla, tanto en su forma difusa como en su forma localizada, tratados mediante resección artroscópica. Material y métodos. Estudio retrospectivo de 24 pacientes diagnosticados por resonancia magnética de SVP local/difusa entre 1996 y 2011. Se trataron 11 casos de forma localizada y 13 de forma difusa. Tras un seguimiento medio de 60 meses (rango: 34-204). Se intervinieron mediante sinovectomía artroscópica y se valoraron funcionalmente en el postoperatorio con los test IKDC, WOMET, Kujala y Tegner. Resultados. Ocho pacientes afectados de SVP difusa recidivaron (un 61,5% de las formas difusas). De ellos 2 requirieron radioterapia, uno cirugía abierta por afectación extraarticular y 5 nueva resección artroscópica sin detectarse posteriormente nueva recidiva. En 6 pacientes se observaron lesiones asociadas (en 3 meniscopatía y en 3 lesiones condrales). No hubo recidivas en la forma localizada. El IKDC mejoró de media 30,6 puntos, el WOMET 37,4 puntos y Kujala 34,03 puntos. Discusión. La SVP resecada mediante técnica artroscópica presenta buenos resultados funcionales y curativos a medio plazo con una baja morbilidad. La forma difusa de la SVP requiere con frecuencia una segunda intervención quirúrgica por su alta tasa de recidiva tras su resección artroscópica (AU)


Introduction. Pigmented villonodular synovitis (PVS) is a synovial proliferation disorder of uncertain aetiology, with some controversy as regards its proper treatment. The purpose of the study was to evaluate the functional outcome and recurrence rate in a series of patients diagnosed with both the diffuse and the localised type of PVS and treated by arthroscopic resection. Material and methods. Twenty-four patients diagnosed with PVS were retrospectively assessed. There were 11 cases with the diffuse type, and 13 cases with the localised type of PVS. They were followed-up for a median of 60 months (range, 34-204). They underwent arthroscopic synovectomy, and were functionally evaluated with IKDC, WOMET, and Kujala scores. Results. There was recurrence in 8 out of 13 (61.5%) cases with the diffuse type of PVS. Two of these patients were treated with radiation. One patient underwent surgical resection with an open procedure due to extra-articular involvement. The remaining 5 patients underwent a second arthroscopic resection, and no recurrence was subsequently observed. Cases with localised PVS did not recur after a single arthroscopic resection. IKDC, WOMET and Kujala scores improved by 30.6, 37.4 and 34.03 points, respectively. Discussion. Pigmented villonodular synovitis treated by arthroscopic resection showed good functional results at mid-term follow-up. A single arthroscopic resection was sufficient to treat the localised PVS, whereas the diffuse type of PVS required a second arthroscopic resection in most cases, due to its high rate of recurrence (AU)


Assuntos
Adolescente , Adulto , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Sinovite Pigmentada Vilonodular/cirurgia , Artroplastia do Joelho/métodos , Antibioticoprofilaxia/métodos , Heparina de Baixo Peso Molecular/uso terapêutico , Sinovite Pigmentada Vilonodular/etiologia , Indicadores Básicos de Saúde , Artroscopia/métodos , Imageamento por Ressonância Magnética , Espectroscopia de Ressonância Magnética/métodos
12.
Rev. Nac. (Itauguá) ; 7(2): 54-55, dic 2015.
Artigo em Espanhol | LILACS, BDNPAR | ID: biblio-884788

RESUMO

RESUMEN Se presenta caso de varón joven con monoartritis aguda debido a sinovitis vellonodular pigmentada.


ABSTRACT If Young male is presented with acute monoarthritis because villonodular pigmented sinovitis.


Assuntos
Humanos , Masculino , Adulto , Sinovite Pigmentada Vilonodular/cirurgia , Sinovite Pigmentada Vilonodular/diagnóstico por imagem , Sinovectomia , Hemossiderina , Articulação do Joelho
15.
Rev. chil. ortop. traumatol ; 51(2): 73-78, 2010.
Artigo em Espanhol | LILACS | ID: lil-618841

RESUMO

Objective: To report our experience in the diagnosis, treatment and follow up of patients with clinical and histopathological diagnosis of knee pigmented villonodular synovitis (PVNS). We performed a descriptive retrospective study of a consecutive series of 10 patients treated by knee PVNS in a ten years period. The mean follow-up was 39 months. Clinical records and surgery protocols were reviewed; functional clinical results were documented using the Lysholm score. Results: Nine patients consulted by pain and one case corresponded a incidental finding. All patients were initially treated with an arthroscopic synovectomy. Two patients presented relapse and as a final treatment they underwent total knee arthroplasty. The mean post-operative Lysholm score at follow up was 95 (90-100) points. Conclusion: We documented low incidence of knee PVNS. The total recurrence in our series was of 20 percent.


Objetivo: Reportar nuestra experiencia en el diagnóstico, tratamiento y evolución de pacientes con diagnóstico clínico-histopatológico de sinovitis villonodular pigmentada (SVNP) de rodilla tratados en nuestro centro. Métodos: Estudio retrospectivo, descriptivo, de una serie consecutiva de diez pacientes tratados por SNVP de rodilla en un período 10 años con un seguimiento promedio de 39 meses. Se revisaron fichas clínicas, protocolos quirúrgicos y documentamos los resultados funcionales subjetivos mediante el puntaje de Lysholm. Resultados: Nueve pacientes consultaron por dolor y en un caso correspondió a un hallazgo. A todos los pacientes se les realizó inicialmente una sinovectomía artroscópica. Dos pacientes presentaron recidiva y como tratamiento final se les realizó una artrosplastía total de rodilla. El promedio del puntaje Lysholm postoperatorio consignado durante el seguimiento fue 95 (90-100). Conclusión: La SVNP de rodilla corresponde a una patología de baja frecuencia, que presenta una recidiva de un 20 por ciento tras un tratamiento artroscópico.


Assuntos
Humanos , Masculino , Adolescente , Adulto , Feminino , Pessoa de Meia-Idade , Artroscopia , Sinovite Pigmentada Vilonodular/cirurgia , Seguimentos , Imageamento por Ressonância Magnética , Membrana Sinovial/cirurgia , Membrana Sinovial/patologia , Recidiva , Estudos Retrospectivos , Joelho/cirurgia , Joelho/patologia , Sinovite Pigmentada Vilonodular/diagnóstico , Resultado do Tratamento
16.
Rev. chil. radiol ; 16(1): 32-35, 2010. ilus
Artigo em Espanhol | LILACS | ID: lil-577486

RESUMO

Pigmented villonodular synovitis represents a benign synovial proliferation associated to hemosiderin deposits, which originates in bone joints, bursae or tendinous sheaths. The knee articulation is the most commonly involved joint (80 percent of the cases), followed by the hip joint. Normally, this pathology has a diffuse presentation, and a small percentage shows a localized form. PVNS displays very specific imaging features, which allows a good diagnostic approach when aided by different radiological techniques, particularly magnetic resonance imaging (MRI). In this report we describe an infrequent case of focal PVNS localized in the hip, which was treated at "Clínica Alemana", Santiago, Chile.


La sinovitis villonodular pigmentada (SVNP) es una proliferación sinovial benigna asociada a depósitos de hemosiderina, que se origina en articulaciones, bursas o vainas tendíneas. La articulación más comprometida es la rodilla (80 por ciento de los casos), seguida por la cadera. Normalmente, esta patología es de presentación difusa y en un menor porcentaje se da en forma focal. La SVNP posee características imaginológicas muy particulares, lo que permite una buena aproximación diagnóstica de la mano de los diferentes métodos radiológicos, en particular la resonancia magnética. En este reporte se describe un caso poco frecuente de SVNP focal en la cadera, que se presentó en la Clínica Alemana de Santiago.


Assuntos
Humanos , Feminino , Adolescente , Quadril/patologia , Imageamento por Ressonância Magnética , Sinovite Pigmentada Vilonodular/diagnóstico , Tomografia Computadorizada por Raios X , Artroscopia , Sinovite Pigmentada Vilonodular/cirurgia
17.
Rev. Asoc. Argent. Ortop. Traumatol ; 73(1): 20-6, marzo 2008. ilus, tab
Artigo em Espanhol | BINACIS | ID: bin-120612

RESUMO

Introducción: La sinovitis vellonodular pigmentada(SVNP) es un trastorno proliferativo idiopático benignoque ocasiona vellosidades o formaciones nodulares en articulaciones, tendones y bolsas serosas. Es una patología infrecuente en el grupo etario pediátrico, por lo que su diagnóstico suele ser tardío. En este trabajo se analizan los métodos de tratamiento utilizados y los resultados funcionales obtenidos en el tratamiento de esta patología. Materiales y métodos: Se analizaron todas las SVNP de rodilla tratadas entre enero de 1988 y junio de 2006. Se estudió la forma de presentación, la demora diagnóstica, el diagnóstico previo, el tipo de tratamiento, las recidivas y la necesidad de tratamientos posteriores. Los hallazgos radiográficos se clasificaron de acuerdo con el sistema propuesto por Flandry y para la evaluación clínica se utilizóel Oxford Knee Score. Resultados: Se evaluaron 9 pacientes con un promedio de edad de 9,8 años. El seguimiento promedio fue de 8,5 años. Cuatro se presentaron en forma difusa, 4 en forma intraarticular y 1 extraarticular. Sólo en 3 casos se observaronhallazgos radiográficos preoperatorios. La demoradiagnóstica fue de 18 meses promedio. La resección serealizó a cielo abierto en 7 casos y artroscópica en 2 casos. El 78 por ciento de los pacientes evidenciaron una función articular satisfactoria en el último control. No hubo recidivas luego de la resección. Conclusiones: La resonancia magnética (RM) es de gran utilidad para la orientación diagnóstica y para determinar la extensión de la lesión. La cirugía es el tratamiento de elección. Los peores resultados funcionales se relacionaron directamente con el tiempo de demora diagnóstica


Assuntos
Criança , Sinovite Pigmentada Vilonodular/cirurgia , Sinovite Pigmentada Vilonodular/diagnóstico , Articulação do Joelho/patologia , Sinovite Pigmentada Vilonodular/epidemiologia , Imageamento por Ressonância Magnética , Seguimentos , Estudos Retrospectivos , Fatores de Tempo , Resultado do Tratamento
18.
Rev. Asoc. Argent. Ortop. Traumatol ; 73(1): 20-26, 2008. ilus, tab
Artigo em Espanhol | LILACS | ID: lil-496189

RESUMO

Introducción: La sinovitis vellonodular pigmentada(SVNP) es un trastorno proliferativo idiopático benignoque ocasiona vellosidades o formaciones nodulares en articulaciones, tendones y bolsas serosas. Es una patología infrecuente en el grupo etario pediátrico, por lo que su diagnóstico suele ser tardío. En este trabajo se analizan los métodos de tratamiento utilizados y los resultados funcionales obtenidos en el tratamiento de esta patología. Materiales y métodos: Se analizaron todas las SVNP de rodilla tratadas entre enero de 1988 y junio de 2006. Se estudió la forma de presentación, la demora diagnóstica, el diagnóstico previo, el tipo de tratamiento, las recidivas y la necesidad de tratamientos posteriores. Los hallazgos radiográficos se clasificaron de acuerdo con el sistema propuesto por Flandry y para la evaluación clínica se utilizóel Oxford Knee Score. Resultados: Se evaluaron 9 pacientes con un promedio de edad de 9,8 años. El seguimiento promedio fue de 8,5 años. Cuatro se presentaron en forma difusa, 4 en forma intraarticular y 1 extraarticular. Sólo en 3 casos se observaronhallazgos radiográficos preoperatorios. La demoradiagnóstica fue de 18 meses promedio. La resección serealizó a cielo abierto en 7 casos y artroscópica en 2 casos. El 78 por ciento de los pacientes evidenciaron una función articular satisfactoria en el último control. No hubo recidivas luego de la resección. Conclusiones: La resonancia magnética (RM) es de gran utilidad para la orientación diagnóstica y para determinar la extensión de la lesión. La cirugía es el tratamiento de elección. Los peores resultados funcionales se relacionaron directamente con el tiempo de demora diagnóstica.


Assuntos
Criança , Articulação do Joelho/patologia , Sinovite Pigmentada Vilonodular/cirurgia , Sinovite Pigmentada Vilonodular/diagnóstico , Estudos Retrospectivos , Seguimentos , Fatores de Tempo , Imageamento por Ressonância Magnética , Resultado do Tratamento , Sinovite Pigmentada Vilonodular/epidemiologia
19.
Artrosc. (B. Aires) ; 14(2): 140-144, dic. 2007. ilus
Artigo em Espanhol | LILACS | ID: lil-475918

RESUMO

Introducción: La sinovitis vellonodular pigmentada (SVNP) es un desorden proliferativo sinovial, de presentacion rara en el grupo etario pediátrico. Objetivos: Reportar 3 casos de SVNP localizada de rodilla, en pacientes con fisis abierta tratados artroscopicamente. Material y métodos: Ambos casos consultaron por dolor, tumefaccion y limitacion de la función. Cada caso fue estudiado con resonancia magnetica, biopsia artroscópica e histología. La evaluacion clínica incluyó rango de movilidad, dolor, presencia de recidivas y necesidad de tratamientos posteriores. Resultados: El promedio de edad fue de 10 años y el seguimiento fue de 4,9 años. La demora diagnóstica promedio fue de 6 meses. Ambos pacientes permanecían asintomaticos al último control, con una funcion articular completa. No se observaron recidivas. Conclusiones: Si bien no es una patologia de presentacion frecuente, debe ser sospechada para evitar daños articulares irreversibles. La resonancia magnetica nuclear es de gran utilidad para la observacion diagnostica y la determinación de la extension. La artroscopía es el tratamiento de eleccion en las formas localizadas.


Assuntos
Criança , Artroscopia , Articulação do Joelho/cirurgia , Articulação do Joelho/patologia , Sinovite Pigmentada Vilonodular/cirurgia , Sinovite Pigmentada Vilonodular/diagnóstico , Sinovite Pigmentada Vilonodular/patologia , Seguimentos , Imageamento por Ressonância Magnética , Resultado do Tratamento
20.
Artrosc. (B. Aires) ; 14(2): 140-144, dic. 2007. ilus
Artigo em Espanhol | BINACIS | ID: bin-122589

RESUMO

Introducción: La sinovitis vellonodular pigmentada (SVNP) es un desorden proliferativo sinovial, de presentacion rara en el grupo etario pediátrico. Objetivos: Reportar 3 casos de SVNP localizada de rodilla, en pacientes con fisis abierta tratados artroscopicamente. Material y métodos: Ambos casos consultaron por dolor, tumefaccion y limitacion de la función. Cada caso fue estudiado con resonancia magnetica, biopsia artroscópica e histología. La evaluacion clínica incluyó rango de movilidad, dolor, presencia de recidivas y necesidad de tratamientos posteriores. Resultados: El promedio de edad fue de 10 años y el seguimiento fue de 4,9 años. La demora diagnóstica promedio fue de 6 meses. Ambos pacientes permanecían asintomaticos al último control, con una funcion articular completa. No se observaron recidivas. Conclusiones: Si bien no es una patologia de presentacion frecuente, debe ser sospechada para evitar daños articulares irreversibles. La resonancia magnetica nuclear es de gran utilidad para la observacion diagnostica y la determinación de la extension. La artroscopía es el tratamiento de eleccion en las formas localizadas.(AU)


Assuntos
Criança , Sinovite Pigmentada Vilonodular/diagnóstico , Sinovite Pigmentada Vilonodular/patologia , Sinovite Pigmentada Vilonodular/cirurgia , Articulação do Joelho/patologia , Articulação do Joelho/cirurgia , Artroscopia , Seguimentos , Resultado do Tratamento , Imageamento por Ressonância Magnética
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