Localized Pigmented Villonodular Synovitis of the Shoulder: a Rare Presentation of an Uncommon Pathology
Autor(a) principal: | |
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Data de Publicação: | 2013 |
Outros Autores: | , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/165 |
Resumo: | Pigmented Vilonodular Synovitis is a rare clinical entity characterized as a synovial membrane benign tumour, despite possible aggressive presentation with articular destruction. The localized variant is four times less frequent and the shoulder involvement is uncommon. We present the case of a Caucasian 59 year-old patient, who presented with left shoulder pain, of uncharacteristic quality, with local swelling and marked functional limitation of 1 month duration. Shoulder ultrasonography showed subacromial bursitis. An ultrasoundguided aspiration was performed: synovial fluid was citrine-colored and translucid. One month later, the patient maintained swelling, pain and functional impairment of the left shoulder. New shoulder ultrasound revealed exuberant subacromial bursitis, which was again aspirated using ultrasound guidance. The synovial fluid was haematic, without changes in the cell count or biochemical analysis and cultural exams. We performed an injection with 60 mg of hexacetonide triamcinolone. Two months later there was a relapse, with shoulder ultrasonography once more showing subacromial bursitis with extensive synovial membrane proliferation. Shoulder MRI revealed subacromial bursitis involving the anterior, posterior and medial recesses, with deltoid distension, but without tendinous or intra-articular involvement. In the interior of the bursa hypointense images in T2 were observed, suggesting the diagnosis of Pigmented Vilonodular Synovitis. The patient had surgical bursectomy with success and without complications. The histological exam of the operatory piececonfirmed the imaging diagnosis. Pigmented Vilonodular Synovitis is uncommon, rarely affecting the shoulder in a localized variant. It is a diagnosis to be considered in shoulder pain, especially if associated with recurrent subacromial bursitis. |
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Localized Pigmented Villonodular Synovitis of the Shoulder: a Rare Presentation of an Uncommon PathologySinovite Vilonodular Pigmentada Circunscrita do Ombro: uma Apresentação Rara de uma Patologia IncomumPigmented Vilonodular Synovitis is a rare clinical entity characterized as a synovial membrane benign tumour, despite possible aggressive presentation with articular destruction. The localized variant is four times less frequent and the shoulder involvement is uncommon. We present the case of a Caucasian 59 year-old patient, who presented with left shoulder pain, of uncharacteristic quality, with local swelling and marked functional limitation of 1 month duration. Shoulder ultrasonography showed subacromial bursitis. An ultrasoundguided aspiration was performed: synovial fluid was citrine-colored and translucid. One month later, the patient maintained swelling, pain and functional impairment of the left shoulder. New shoulder ultrasound revealed exuberant subacromial bursitis, which was again aspirated using ultrasound guidance. The synovial fluid was haematic, without changes in the cell count or biochemical analysis and cultural exams. We performed an injection with 60 mg of hexacetonide triamcinolone. Two months later there was a relapse, with shoulder ultrasonography once more showing subacromial bursitis with extensive synovial membrane proliferation. Shoulder MRI revealed subacromial bursitis involving the anterior, posterior and medial recesses, with deltoid distension, but without tendinous or intra-articular involvement. In the interior of the bursa hypointense images in T2 were observed, suggesting the diagnosis of Pigmented Vilonodular Synovitis. The patient had surgical bursectomy with success and without complications. The histological exam of the operatory piececonfirmed the imaging diagnosis. Pigmented Vilonodular Synovitis is uncommon, rarely affecting the shoulder in a localized variant. It is a diagnosis to be considered in shoulder pain, especially if associated with recurrent subacromial bursitis.A Sinovite Vilonodular Pigmentada é uma entidade clínica rara caracterizada como um tumor benigno da membrana sinovial, apesar de possível apresentação agressiva com destruição articular. A variante circunscrita é quatro vezes menos frequente e o envolvimento do ombro é incomum. Apresentamos o caso de uma doente de 59 anos de idade, que apresentava omalgia à esquerda, incaracterística, com tumefacção local e limitação funcional de um mês de duração. A ecografia do ombro mostrou bursite subacromial. Foi efectuada uma aspiração ecoguiada: o líquido sinovial era translúcido e de cor citrina. Um mês mais tarde, a doente mantinha tumefacção, dor e incapacidade funcional do ombro esquerdo. Foi efectuada nova ecografia do ombro, que revelou bursite subacromial exuberante, que foi novamente aspirada com apoio ecográfico. O líquido sinovial era hemático, sem alterações nos exames culturais e citoquímico. Efectuou-se injecção ecoguiada na bursa com 80 mg de hexacetonido de triamcinolona. Dois meses mais tarde houverecorrência de sintomas e a ecografia mostrou uma vez mais bursite subacromial com proliferação sinovial extensa. A RMN do ombro revelou bursite subacromial envolvendo os recessos anteriores, posterior e interno, com distensão do deltóide, mas sem envolvimento tendinoso ou intra-articular. No interior da bursa observaram-se imagens hipointensas em T2, sugerindo o diagnóstico de Sinovite Vilonodular Pigmentada. A doente foi sujeita a bursectomia cirúrgica, com sucesso e sem complicações. O exame histológico da peça operatória confirmou o diagnóstico imagiológico. A Sinovite Vilonodular Pigmentada é incomum, raramente afectando o ombro na variante circunscrita. É um diagnóstico a ser considerado na omalgia, especialmente se associado a bursite subacromial recorrente.Ordem dos Médicos2013-08-30info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfimage/tiffimage/tiffimage/tiffapplication/unknownhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/165oai:ojs.www.actamedicaportuguesa.com:article/165Acta Médica Portuguesa; Vol. 26 No. 4 (2013): July-August; 459-462Acta Médica Portuguesa; Vol. 26 N.º 4 (2013): Julho-Agosto; 459-4621646-07580870-399Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPenghttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/165https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/165/3721https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/165/6786https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/165/6787https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/165/6788https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/165/6810Madruga Dias, JoãoCosta, Maria ManuelaDuarte, ArturPereira da Silva, José A.info:eu-repo/semantics/openAccess2022-12-20T10:55:51Zoai:ojs.www.actamedicaportuguesa.com:article/165Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:16:22.957620Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Localized Pigmented Villonodular Synovitis of the Shoulder: a Rare Presentation of an Uncommon Pathology Sinovite Vilonodular Pigmentada Circunscrita do Ombro: uma Apresentação Rara de uma Patologia Incomum |
title |
Localized Pigmented Villonodular Synovitis of the Shoulder: a Rare Presentation of an Uncommon Pathology |
spellingShingle |
Localized Pigmented Villonodular Synovitis of the Shoulder: a Rare Presentation of an Uncommon Pathology Madruga Dias, João |
title_short |
Localized Pigmented Villonodular Synovitis of the Shoulder: a Rare Presentation of an Uncommon Pathology |
title_full |
Localized Pigmented Villonodular Synovitis of the Shoulder: a Rare Presentation of an Uncommon Pathology |
title_fullStr |
Localized Pigmented Villonodular Synovitis of the Shoulder: a Rare Presentation of an Uncommon Pathology |
title_full_unstemmed |
Localized Pigmented Villonodular Synovitis of the Shoulder: a Rare Presentation of an Uncommon Pathology |
title_sort |
Localized Pigmented Villonodular Synovitis of the Shoulder: a Rare Presentation of an Uncommon Pathology |
author |
Madruga Dias, João |
author_facet |
Madruga Dias, João Costa, Maria Manuela Duarte, Artur Pereira da Silva, José A. |
author_role |
author |
author2 |
Costa, Maria Manuela Duarte, Artur Pereira da Silva, José A. |
author2_role |
author author author |
dc.contributor.author.fl_str_mv |
Madruga Dias, João Costa, Maria Manuela Duarte, Artur Pereira da Silva, José A. |
description |
Pigmented Vilonodular Synovitis is a rare clinical entity characterized as a synovial membrane benign tumour, despite possible aggressive presentation with articular destruction. The localized variant is four times less frequent and the shoulder involvement is uncommon. We present the case of a Caucasian 59 year-old patient, who presented with left shoulder pain, of uncharacteristic quality, with local swelling and marked functional limitation of 1 month duration. Shoulder ultrasonography showed subacromial bursitis. An ultrasoundguided aspiration was performed: synovial fluid was citrine-colored and translucid. One month later, the patient maintained swelling, pain and functional impairment of the left shoulder. New shoulder ultrasound revealed exuberant subacromial bursitis, which was again aspirated using ultrasound guidance. The synovial fluid was haematic, without changes in the cell count or biochemical analysis and cultural exams. We performed an injection with 60 mg of hexacetonide triamcinolone. Two months later there was a relapse, with shoulder ultrasonography once more showing subacromial bursitis with extensive synovial membrane proliferation. Shoulder MRI revealed subacromial bursitis involving the anterior, posterior and medial recesses, with deltoid distension, but without tendinous or intra-articular involvement. In the interior of the bursa hypointense images in T2 were observed, suggesting the diagnosis of Pigmented Vilonodular Synovitis. The patient had surgical bursectomy with success and without complications. The histological exam of the operatory piececonfirmed the imaging diagnosis. Pigmented Vilonodular Synovitis is uncommon, rarely affecting the shoulder in a localized variant. It is a diagnosis to be considered in shoulder pain, especially if associated with recurrent subacromial bursitis. |
publishDate |
2013 |
dc.date.none.fl_str_mv |
2013-08-30 |
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info:eu-repo/semantics/article |
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/165 oai:ojs.www.actamedicaportuguesa.com:article/165 |
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/165 |
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oai:ojs.www.actamedicaportuguesa.com:article/165 |
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eng |
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eng |
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/165 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/165/3721 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/165/6786 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/165/6787 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/165/6788 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/165/6810 |
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Ordem dos Médicos |
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Ordem dos Médicos |
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Acta Médica Portuguesa; Vol. 26 No. 4 (2013): July-August; 459-462 Acta Médica Portuguesa; Vol. 26 N.º 4 (2013): Julho-Agosto; 459-462 1646-0758 0870-399X reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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