1/26. Tuberculous synovitis of the elbow joint.Tuberculous synovitis in the elbow joint is extremely rare in developed countries. We describe a 68-year-old man who had had a gradually enlarging mass over the volar side of the left proximal forearm near the elbow joint for 4 months. Plain roentgenograms of the diseased elbow showed early osteoarthritic change. magnetic resonance imaging revealed diffuse synovitis with a large 8 x 8 cm extra-articular synovial cyst. Synovectomy was performed and histopathologic examination of the surgical specimen revealed granulomatous inflammation with caseation, prominent Langhan's giant cells, and sparse acid-fast bacilli. The patient had been receiving antituberculous chemotherapy for at least 8 months at the time of examination and had no recurrence of swelling or discharging sinuses during follow-up. Differential diagnoses in patients with elbow swelling should include pigmented villonodular synovitis, hemophilic arthropathy, rheumatoid arthritis, degenerative joint disease, and tuberculosis. Simple aspiration may enable earlier diagnosis, before destructive arthropathy becomes advanced.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
2/26. Giant synovial cyst of the calf and thigh in a patient with granulomatous synovitis.A giant synovial cyst with granulomatous synovitis was removed from the thigh and calf in an 80-year-old woman. The lesion included necrotizing, epitheloid cell granulomata with Langhans' type giant cells. Chest X-ray, tuberculin testing, cultures for Acid Fast bacilli, as well as aerobic, anaerobic and fungal cultures were all negative. The treatment consisted of synovectomy and total knee arthroplasty with an uneventful recovery. A giant calf cyst, usually associated with rheumatoid arthritis, but in this situation, noted in granulomatous synovitis seems not to have been reported previously.- - - - - - - - - - ranking = 3keywords = giant (Clic here for more details about this article) |
3/26. Granulomatous synovitis after intraarticular Hylan GF-20. A report of two cases.Intraarticular hyaluronan injections are used to treat osteoarthritis of the knee. Acute painful swelling with a joint effusion develops locally after the injection in about 10% of cases but resolves spontaneously. Crystals are identifiable in some patients, but the mechanism in crystal-negative cases remains unknown. We report knee arthritis with inflammatory joint fluid free of organisms and crystals in two patients after Hylan GF-20 treatment for femorotibial osteoarthritis. synovial membrane histology disclosed granulomatous synovitis with epithelioid histiocytic and multinucleate giant cells but no visible foreign bodies. These two cases suggest that crystal-negative arthritis after Hylan GF-20 injection may be ascribable to granulomatous synovitis of the foreign-body giant-cell type.- - - - - - - - - - ranking = 2keywords = giant (Clic here for more details about this article) |
4/26. Patellofemoral arthritis due to localize nodular synovitis (LNS).We present the case of a 38-year-old female patient who had suffered from a progressively increasing anterior pain in her right knee for almost 10 years. She decided to seek medical advice when the pain became intolerable, not permitting her to perform normal everyday activities. The clinical examination showed evidence of patellofemoral arthritis, but the MRI that followed, apart from confirming the original diagnosis as an "Outerbridge" grade III osteoarthritic lesion, revealed an unidentifiable tumor located in the lateral part of the right patellofemoral joint, that appeared to be like a type of "reactive synovitis". The articular degeneration was treated with arthroscopic saving, followed by complete excision of the tumor and anteromedial tibial tubercle transfer under direct vision. The excised tumor was histologically categorized as a "localized type of nodular synovitis" otherwise known as "giant cell" tumor of synovial origin. The patient has fully recoreved from surgery and 3 years post-operatively she has fully returned to everyday normal activities noting only occasional slight discomfort.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
5/26. The acute carpal tunnel syndrome: nine case reports.Nine cases of acute carpal tunnel syndrome are reported. Etiologies include: bleeding secondary to chronic lymphatic leukemia; colles' fracture of the wrist (2 cases); Epiphyseal fracture (Salter II) of the distal radius; Bleeding secondary to giant cell tumor of the tendon sheath; Unstable distal radio-ulnar joint; Displaced intra-articular fracture of the distal radius; Rheumatoid synovitis and vasculitis; Trans-scaphoid, perilunar fracture dislocation of the wrist. Early recognition of median nerve compression in the carpal tunnel is vital. The signs of median nerve compression should be looked for in all cases of wrist trauma. In our opinion, immediate surgical decompression is frequently indicated.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
6/26. Pigmented villonodular synovitis of the temporomandibular joint. Case Report.Pigmented villonodular synovitis is a lesion containing giant cells and, because of its tendency to recur, it is easily confused with a malignant process. However, careful review of the histological material will reveal that there is no nuclear atypism or mitotic figures. Also, there have been no reports attributing metastases or death to thid disease. The clinical course of our case was definitely benign.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
7/26. Malignant giant cell tumor of synovium and locally destructive pigmented villonodular synovitis: ultrastructural and immunohistochemical study and review of the literature.The first reported case of an intraarticular malignant giant cell tumor of synovium studied with electron microscopic and immunohistochemical examination is presented, together with a case of diffuse intraarticular pigmented villonodular synovitis with extensive bone destruction. The malignant case was dominated by uniform cells positive for histiocytic markers, the fine structure showing a gradual change from cells dominated by organelles serving a secretory function to cells with phagocytic activity. The reported cases of giant cell tumor of the tendon sheath indicate that the pertinent histologic changes regarding malignancy are an increase in cell polymorphism and in the number of mitoses, and a decrease in the number of multinucleated giant cells.- - - - - - - - - - ranking = 7keywords = giant (Clic here for more details about this article) |
8/26. Diffuse pigmented villonodular synovitis of the temporomandibular joint diagnosed by fine-needle aspiration cytology.Diffuse pigmented villonodular synovitis is a rare tumor in the temporomandibular joint region. This article deals with a 32-yr-old male who suffered from pain and swelling in the right temporomandibular joint region associated with restricted mouth opening. Computed tomography showed a tumor lateral to the temporomandibular joint. arthrography revealed a displaced temporomandibular joint disk. Fine-needle aspiration cytology showed characteristic cellular changes, including rounded or oval cells with abundant cytoplasm and intracytoplasmatic hemosiderin deposits and numerous multinucleated giant cells without nuclear atypia. A benign mesenchymal lesion suggestive for pigmented villonodular synovitis was diagnosed and later verified at histologic examination. Fine-needle aspiration cytology seems to be useful for this diagnosis.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
9/26. Oncogenic hypophosphatemic osteomalacia associated with a giant cell tumour of a tendon sheath.We report a case of oncogenic hypophosphatemic osteomalacia, a rare form of osteomalacia, secondary to a diffuse giant cell tumour of tendon sheath. Possible pathogenic factors are discussed in the light of previously described clinical and experimental observations.- - - - - - - - - - ranking = 5keywords = giant (Clic here for more details about this article) |
10/26. Concentric joint space narrowing of the hip associated with hemosiderotic synovitis (HS) including pigmented villonodular synovitis (PVNS).Concentric joint space narrowing of the hip is an expected radiographic finding in cases of inflammatory arthritis such as rheumatoid arthritis or sepsis. However, similar joint space narrowing is associated with chronic hemorrhagic conditions that produce hemosiderotic synovitis. Hemosiderotic synovitis results from chronic intra-articular bleeding such as occurs in pigmented villonodular synovitis, generalized bleeding diathesis, synovial hemangioma, and chronic trauma. Five hips in five patients with concentric joint space narrowing not associated with inflammatory arthritis or with hemophilia were reviewed clinically, radiographically, and pathologically. All patients had a hemosiderotic synovitis. The definitive diagnosis of pigmented villonodular synovitis was made pathologically in two cases that demonstrated nodular areas of giant cell proliferation, collagen production, and lipid-laden histiocytes on histologic samples.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
| | Next -> |