Possibilities of ultrasonography in the diagnosis of pigmented villonodular synovitis. Clinical case

IF 0.2 Q4 MEDICINE, GENERAL & INTERNAL
V.M. Zhdan, I.V. Ivanytskyi, M.Y. Babanina, T.A. Ivanytska, Y.M. Kitura, H.V. Volchenko, M.V. Tkachenko, O.A. Kyrian, V.H. Lebid
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引用次数: 0

Abstract

Pigmented villonodular synovitis is a rare proliferative disease of the synovial membrane, which most often affects the knee joints. Being a benign disease, at the same time, this pathology is often aggressive, and in some cases spreads to the soft tissues outside the joint. There are two forms of monoarticular damage: localized and diffuse. The diffuse form gives frequent relapses. To date, there are no standards for the management of this disease, just as there are no early markers for the detection of pigmented villonodular synovitis. This joint lesion has a long asymptomatic course, or it has symptoms of non-specific recurrent arthritis, so the patients can later be referred for magnetic resonance imaging, which is the only non-invasive method of diagnosing this pathology. At the same time, in modern conditions, most patients with recurrent synovitis will undergo an ultrasound examination of the joint according to the diagnostic standards. Ultrasonography made for abovementioned synovitis is insufficiently described in the medical literature. The aim of our study was to highlight the current data on the diagnosis and management of patients with pigmented villonodular synovitis and to describe our own clinical case. A feature of our clinical case was the detection of characteristic symptoms using ultrasonography. Irregular thickening of the synovial membrane with nodular forma­tions and villous growths, with the length of villi up to 7 mm near the patella with single loci of blood flow, was revealed by ultrasound examination and power Doppler mapping. Shear wave elastometry of the synovial membrane was performed. It demonstrated a significant increase in the stiffness of the synovial membrane, which can be a patho­gnomonic symptom of this pathology. The diagnosis of villonodular synovitis was confirmed histologically after surgical treatment. Subsequently, the patient had a recurrence of the pigmented villonodular synovitis, which was also detected by ultrasound diagnostics. Thus, pigmented villonodular synovitis of the knee joint is a rather rare pathology that requires differential diagnosis with inflammatory joint diseases. The final diagnosis is based on histological exa­mination. MRI and ultrasound diagnostics are non-invasive methods that can detect this pathology with high accuracy. The advantage of ultrasonography is its availability and non-invasiveness. The increase in stiffness of the synovial membrane along with its proliferation, which we found, can serve as an additional criterion of villonodular synovitis, and, according to the data available to us, has not been described in the literature so far.
超声诊断色素性绒毛结节性滑膜炎的可能性。临床病例
摘要色素绒毛结节性滑膜炎是一种罕见的滑膜增生性疾病,最常影响膝关节。作为一种良性疾病,同时,这种病理往往具有侵袭性,在某些情况下会扩散到关节外的软组织。单关节损伤有两种形式:局部损伤和弥漫性损伤。弥漫性复发频繁。到目前为止,对于这种疾病的管理没有标准,就像没有检测色素绒毛结节性滑膜炎的早期标记物一样。这种关节病变病程较长,或者有非特异性复发性关节炎的症状,因此患者以后可以转诊磁共振成像,这是诊断这种病理的唯一无创方法。同时,在现代条件下,大多数复发性滑膜炎患者都会根据诊断标准对关节进行超声检查。超声检查对上述滑膜炎的描述在医学文献中不够充分。我们的研究的目的是强调目前的数据诊断和治疗患者的色素绒毛结节性滑膜炎和描述我们自己的临床病例。我们的临床病例的一个特点是使用超声检查的特征性症状。超声检查和功率多普勒成像显示髌骨附近滑膜不规则增厚,结节状形成和绒毛生长,绒毛长度可达7mm,血流单位点。对滑膜进行横波弹性测量。它显示了滑膜刚度的显著增加,这可能是这种病理的病理-症状。经手术治疗后病理证实为绒毛结节性滑膜炎。随后,患者复发了色素绒毛结节性滑膜炎,超声诊断也发现了这一点。因此,膝关节色素绒毛结节性滑膜炎是一种相当罕见的病理,需要与炎性关节疾病鉴别诊断。最终诊断基于组织学检查。MRI和超声诊断是非侵入性的方法,可以高精度地检测出这种病理。超声检查的优点是它的可用性和无创性。我们发现,滑膜硬度的增加及其增生可以作为绒毛结节性滑膜炎的附加标准,根据我们现有的资料,迄今为止尚未在文献中描述。
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来源期刊
Medical Perspectives-Medicni Perspektivi
Medical Perspectives-Medicni Perspektivi MEDICINE, GENERAL & INTERNAL-
CiteScore
0.40
自引率
0.00%
发文量
85
审稿时长
9 weeks
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