Pigmented Villonodular Synovitis in Children – A Case Series
Journal Title: Surgery & Case Studies: Open Access Journal - Year 2019, Vol 1, Issue 5
Abstract
A 11-year-old girl was referred by the Orthopaedic team with swelling of her right knee which started five months back. She had no systemic symptoms or preceding trauma or infection. She was seen by the Orthopaedic team, who aspirated the joint and injected it with steroids, once the cultures came back as negative. She had a good response, although the swelling returned after 8-10 weeks, associated with some stiffness. She was previously fit and well except for visual impairment in her left eye due to Persistent Hyperplastic Primary Vitreous (PHPV). Her examination revealed moderate effusion in her right knee. Her blood tests including inflammatory markers were normal. With a diagnosis of oligoarticular JIA, she had a further intra-articular steroid injection with good response lasting 4 months. Subsequently she required two more steroid injections in the same joint within six months, at which stage she was commenced on weekly Methotrexate injections at 15mg/m2. Despite that, the swelling recurred, which did not respond to intra-articular steroid injection, following which MRI scan was requested. This showed diffuse synovial proliferation with relatively low signal components in some areas, suggestive of diffuse PVNS (Figure 1). Her immunosuppression was stopped, and she was referred for synovectomy.
Authors and Affiliations
K Warrier, S Deepak
Keywords
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- EP ID EP639331
- DOI 10.32474/SCSOAJ.2019.01.000123
- Views 65
- Downloads 0
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