Skip to main content
SpringerLink
Log in

Magnetic resonance imaging features of intra-articular tenosynovial giant cell tumor in children

  • Original Article
  • Published:
Pediatric Radiology Aims and scope Submit manuscript

Abstract

Background

Magnetic resonance imaging (MRI) plays a critical role in disease characterization of intra-articular tenosynovial giant cell tumor.

Objective

To characterize the MRI features of intra-articular tenosynovial giant cell tumor in children with respect to disease subtype and anatomical location.

Materials and methods

This retrospective study included children with tenosynovial giant cell tumor who underwent preoperative MRI between January 2006 and May 2020. Two radiologists reviewed each examination to determine disease subtype, signal intensities and the presence of an effusion, osseous changes, chondromalacia, juxtacapsular disease and concomitant joint involvement. Fisher exact, Mann-Whitney U, and Kruskal-Wallis H tests were used to compare findings between subtypes and locations.

Results

Twenty-four children (16 girls, 8 boys; mean age: 13.1±3.8 years) with 19 knee and 5 ankle-hindfoot tenosynovial giant cell tumor had either diffuse (n=15) or localized (n=9) disease. An effusion (P=0.004) was significantly more common with diffuse than localized disease. There was no significant difference in MRI signal (P-range: 0.09–1) or other imaging findings (P-range: 0.12–0.67) between subtypes. Children with knee involvement were significantly more likely to present with diffuse disease while those with ankle-hindfoot involvement all presented with focal disease (P=0.004). Juxtacapsular (n=4) and concomitant proximal tibiofibular joint involvement (n=5) were observed with diffuse disease in the knee. Erosions (P=0.01) were significantly more common in the ankle than in the knee.

Conclusion

In our study, diffuse tenosynovial giant cell tumor was more common than localized disease, particularly in the knee where juxtacapsular and concomitant proximal tibiofibular joint disease can occur.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. Murphey MD, Rhee JH, Lewis RB et al (2008) Pigmented villonodular synovitis: radiologic-pathologic correlation. Radiographics 28:1493–1518

    Article  Google Scholar 

  2. Baroni E, Russo BD, Masquijo JJ et al (2010) Pigmented villonodular synovitis of the knee in skeletally immature patients. J Child Orthop 4:123–127

    Article  Google Scholar 

  3. Myers BW, Masi AT (1980) Pigmented villonodular synovitis and tenosynovitis: a clinical epidemiologic study of 166 cases and literature review. Medicine 59:223–238

    Article  CAS  Google Scholar 

  4. Xie G-P, Jiang N, Liang C-X et al (2015) Pigmented villonodular synovitis: a retrospective multicenter study of 237 cases. PLoS One 10:e0121451

    Article  Google Scholar 

  5. Chin KR, Barr SJ, Winalski C et al (2002) Treatment of advanced primary and recurrent diffuse pigmented villonodular synovitis of the knee. J Bone Joint Surg Am 84:2192–2202

    Article  Google Scholar 

  6. Eckhardt BP, Hernandez RJ (2004) Pigmented villonodular synovitis: MR imaging in pediatric patients. Pediatr Radiol 34:943–947

    Article  Google Scholar 

  7. Nguyen JC, De Smet AA, Graf BK, Rosas HG (2014) MR imaging-based diagnosis and classification of meniscal tears. Radiographics 34:981–999

    Article  Google Scholar 

  8. Kan JH, Hernanz-Schulman M, Damon BM et al (2008) MRI features of three paediatric intra-articular synovial lesions: a comparative study. Clin Radiol 63:805–812

    Article  CAS  Google Scholar 

  9. Cheng XG, You YH, Liu W et al (2004) MRI features of pigmented villonodular synovitis (PVNS). Clin Rheumatol 23:31–34

    Article  Google Scholar 

  10. Hughes TH, Sartoris DJ, Schweitzer ME, Resnick DL (1995) Pigmented villonodular synovitis: MRI characteristics. Skeletal Radiol 24:7–12

  11. Huang G-S, Lee C-H, Chan WP et al (2003) Localized nodular synovitis of the knee: MR imaging appearance and clinical correlates in 21 patients. AJR Am J Roentgenol 181:539–543

    Article  Google Scholar 

  12. Llauger J, Palmer J, Rosón N et al (1999) Pigmented villonodular synovitis and giant cell tumors of the tendon sheath: radiologic and pathologic features. AJR Am J Roentgenol 172:1087–1091

    Article  CAS  Google Scholar 

  13. Brien EW, Sacoman DM, Mirra JM (2004) Pigmented villonodular synovitis of the foot and ankle. Foot Ankle Int 25:908–913

    Article  Google Scholar 

  14. Mastboom MJL, Palmerini E, Verspoor FGM et al (2019) Surgical outcomes of patients with diffuse-type tenosynovial giant-cell tumours: an international, retrospective, cohort study. Lancet Oncol 20:877–886

    Article  Google Scholar 

  15. Mastboom MJL, Staals EL, Verspoor FGM et al (2019) Surgical treatment of localized-type tenosynovial giant ecll tumors of large joints: a study based on a multicenter-pooled database of 31 international sarcoma centers. J Bone Joint Surg Am 101:1309–1318

    Article  CAS  Google Scholar 

  16. Neubauer P, Weber AK, Miller NH, McCarthy EF (2007) Pigmented villonodular synovitis in children: a report of six cases and review of the literature. Iowa Orthop J 27:90–94

    PubMed  PubMed Central  Google Scholar 

  17. Turkucar S, Makay B, Tatari H, Unsal E (2019) Pigmented villonodular synovitis: four pediatric cases and brief review of literature. J Postgrad Med 65:233–236

    Article  CAS  Google Scholar 

  18. Willimon SC, Busch MT, Perkins CA (2018) Pigmented villonodular synovitis of the knee: an underappreciated source of pain in children and adolescents. J Pediatr Orthop 38:e482–e485

    Article  Google Scholar 

  19. Hao DP, Zhang JZ, Xu WJ et al (2011) Pigmented villonodular synovitis of the ankle: radiologic characteristics. J Am Podiatr Med Assoc 101:252–258

    Article  Google Scholar 

  20. Akgün I, Ogüt T, Kesmezacar H, Dervisoglu S (2003) Localized pigmented villonodular synovitis of the knee. Orthopedics 26:1131–1135

    PubMed  Google Scholar 

  21. Ottaviani S, Ayral X, Dougados M, Gossec L (2011) Pigmented villonodular synovitis: a retrospective single-center study of 122 cases and review of the literature. Semin Arthritis Rheum 40:539–546

    Article  Google Scholar 

  22. Mastboom MJL, Verspoor FGM, Hanff DF et al (2018) Severity classification of tenosynovial giant cell tumours on MR imaging. Surg Oncol 27:544–550

    Article  CAS  Google Scholar 

  23. Saxena A, Perez H (2004) Pigmented villonodular synovitis about the ankle: a review of the literature and presentation in 10 athletic patients. Foot Ankle Int 25:819–826

    Article  Google Scholar 

  24. Rochwerger A, Groulier P, Curvale G, Launay F (1999) Pigmented villonodular synovitis of the foot and ankle: a report of eight cases. Foot Ankle Int 20:587–590

    Article  CAS  Google Scholar 

  25. Aşik M, Erlap L, Altinel L, Cetik O (2001) Localized pigmented villonodular synovitis of the knee. Arthroscopy 17:1–6

    Google Scholar 

  26. Kim DE, Kim JM, Lee BS et al (2018) Distinct extra-articular invasion patterns of diffuse pigmented villonodular synovitis/tenosynovial giant cell tumor in the knee joints. Knee Surg Sports Traumatol Arthrosc 26:3508–3514

    Article  Google Scholar 

  27. De Maeseneer M, Van Roy P, Shahabpour M et al (2004) Normal anatomy and pathology of the posterior capsular area of the knee: findings in cadaveric specimens and in patients. AJR Am J Roentgenol 182:955–962

  28. Steinbach LS, Neumann CH, Stoller DW et al (1989) MRI of the knee in diffuse pigmented villonodular synovitis. Clin Imaging 13:305–316

    Article  CAS  Google Scholar 

  29. Herman AM, Marzo JM (2014) Popliteal cysts: a current review. Orthopedics 37:e678–e684

    Article  Google Scholar 

  30. Chin KR, Brick GW (2002) Extraarticular pigmented villonodular synovitis: a cause for failed knee arthroscopy. Clin Orthop Relat Res 404:330–338

    Article  Google Scholar 

  31. Lin J, Jacobson JA, Jamadar DA, Ellis JH (1999) Pigmented villonodular synovitis and related lesions: the spectrum of imaging findings. AJR Am J Roentgenol 172:191–197

    Article  CAS  Google Scholar 

  32. Somerhausen NS, Fletcher CD (2000) Diffuse-type giant cell tumor: clinicopathologic and immunohistochemical analysis of 50 cases with extraarticular disease. Am J Surg Pathol 24:479–492

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiology, Children’s Hospital of Philadelphia, 3401 Civic Center Blvd., Philadelphia, PA, 19104, USA

    Jie C. Nguyen, David M. Biko & Michael K. Nguyen

  2. University of Pennsylvania School of Medicine, Philadelphia, PA, USA

    Jie C. Nguyen, David M. Biko, Kristy L. Weber, Theodore J. Ganley & Alexandre Arkader

  3. Drexel University College of Medicine, Philadelphia, PA, USA

    Sammy Othman

  4. Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia, PA, USA

    Kristy L. Weber

  5. Division of Orthopedic Surgery, Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Theodore J. Ganley & Alexandre Arkader

Authors
  1. Jie C. Nguyen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. David M. Biko
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Michael K. Nguyen
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Sammy Othman
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Kristy L. Weber
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Theodore J. Ganley
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Alexandre Arkader
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jie C. Nguyen.

Ethics declarations

Conflicts of interest

None

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Nguyen, J.C., Biko, D.M., Nguyen, M.K. et al. Magnetic resonance imaging features of intra-articular tenosynovial giant cell tumor in children. Pediatr Radiol 51, 441–449 (2021). https://doi.org/10.1007/s00247-020-04861-4

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00247-020-04861-4

Keywords

Search

Navigation