F. Flandry et al., DIAGNOSTIC FEATURES OF DIFFUSE PIGMENTED VILLONODULAR SYNOVITIS OF THE KNEE, Clinical orthopaedics and related research, (298), 1994, pp. 212-220
Twenty-five cases of diffuse pigmented villonodular synovitis of the k
nee in 23 patients were reviewed to identify characteristic clinical p
resentations and histologic findings. All cases met strict histologic
criteria for diagnosis. Clinical presentation consisted of insidious a
nd progressive symptoms of significant joint swelling with discomfort,
but not isolated pain. On physical examination, a suprapatellar pouch
that was markedly distended by either effusion, synovial masses, or b
oth, and a slight flexion posture were the most consistent findings. A
spiration to detect a bloody effusion was unreliable as a diagnostic t
ool. Pigmentation was absent in 16% of the gross specimens. Histologic
ally, iron deposition was present in all cases and to a moderate or ma
rked degree in most. Fibrosis, hyalinization, and chronic inflammatory
changes were present in most, but to a lesser degree. No patient had
gross, histologic, or treatment follow-up findings consistent with neo
plasia. Attempts to predict clinical outcome based on histologic findi
ngs mere unrewarding.