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Musculoskeletal
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Arthritis
Miscellaneous Joint Disorders
Tenosynovial Giant Cell Tumor, Intraarticular
Tenosynovial Giant Cell Tumor, Intraarticular
Derik L. Davis, MD; B. J. Manaster, MD, PhD, FACR
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KEY FACTS

  • Imaging

    • Top Differential Diagnoses

      • Clinical Issues

        TERMINOLOGY

        • Synonyms

          • Formerly pigmented villonodular synovitis (PVNS)
          • Benign synovioma; focal nodular synovitis

        • Definitions

          • Low-grade fibrohistiocytic proliferation with hemosiderin deposits in synovial joints
          • 2 subtypes
            • Diffuse tenosynovial giant cell tumor (TSGCT)
            • Localized TSGCT

        IMAGING

        • General Features

          • Radiographic Findings

            • CT Findings

              • MR Findings

                • Ultrasonographic Findings

                  • Nuclear Medicine Findings

                    • Imaging Recommendations

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          • Gross Pathologic & Surgical Features

                            • Microscopic Features

                              CLINICAL ISSUES

                              • Presentation

                                • Demographics

                                  • Natural History & Prognosis

                                    • Treatment

                                      DIAGNOSTIC CHECKLIST

                                      • Consider

                                        • Image Interpretation Pearls

                                          Selected References

                                          1. Crim J et al: Limited usefulness of classic MR findings in the diagnosis of tenosynovial giant cell tumor. Skeletal Radiol. 50(8):1585-91, 2021
                                          2. Finkelstein D et al: Differential diagnosis of T2 hypointense masses in musculoskeletal MRI. Skeletal Radiol. 50(10):1981-94, 2021
                                          3. Ota T et al: Tumor location and type affect local recurrence and joint damage in tenosynovial giant cell tumor: a multi-center study. Sci Rep. 11(1):17384, 2021
                                          4. Spierenburg G et al: Management of tenosynovial giant cell tumour of the foot and ankle. Bone Joint J. 103-B(4):788-94, 2021
                                          5. Dundar A et al: Unusual manifestations of diffuse-type tenosynovial giant cell tumor in two patients: importance of radiologic-pathologic correlation. Skeletal Radiol. 49(3):483-9, 2020
                                          6. Tap W: ENLIVEN study: Pexidartinib for tenosynovial giant cell tumor (TGCT). Future Oncol. 16(25):1875-8, 2020
                                          7. Gouin F et al: Localized and diffuse forms of tenosynovial giant cell tumor (formerly giant cell tumor of the tendon sheath and pigmented villonodular synovitis). Orthop Traumatol Surg Res. 103(1S):S91-7, 2017
                                          8. Mollon B et al: Combined arthroscopic and open synovectomy for diffuse pigmented villonodular synovitis of the knee. Knee Surg Sports Traumatol Arthrosc. 24(1):260-6, 2014
                                          9. Verspoor FG et al: Long-term follow-up results of primary and recurrent pigmented villonodular synovitis. Rheumatology (Oxford). 53(11):2063-70, 2014
                                          10. Aurégan JC et al: Primary arthroscopic synovectomy for pigmented villo-nodular synovitis of the knee: recurrence rate and functional outcomes after a mean follow-up of seven years. Orthop Traumatol Surg Res. 99(8):937-43, 2013
                                          11. Botez P et al: Adult multifocal pigmented villonodular synovitis--clinical review. Int Orthop. 37(4):729-33, 2013
                                          12. Colman MW et al: Does combined open and arthroscopic synovectomy for diffuse PVNS of the knee improve recurrence rates? Clin Orthop Relat Res. 471(3):883-90, 2013
                                          13. Berger B et al: External beam radiotherapy as postoperative treatment of diffuse pigmented villonodular synovitis. Int J Radiat Oncol Biol Phys. 67(4):1130-4, 2007
                                          14. Ward WG Sr et al: Diffuse pigmented villonodular synovitis: preliminary results with intralesional resection and p32 synoviorthesis. Clin Orthop Relat Res. 454:186-91, 2007
                                          15. Wu CC et al: Two incision synovectomy and radiation treatment for diffuse pigmented villonodular synovitis of the knee with extra-articular component. Knee. 14(2):99-106, 2007
                                          16. Chiari C et al: What affects the recurrence and clinical outcome of pigmented villonodular synovitis? Clin Orthop Relat Res. 450:172-8, 2006
                                          17. Finis K et al: Analysis of pigmented villonodular synovitis with genome-wide complementary DNA microarray and tissue array technology reveals insight into potential novel therapeutic approaches. Arthritis Rheum. 54(3):1009-19, 2006
                                          18. Mendenhall WM et al: Pigmented villonodular synovitis. Am J Clin Oncol. 29(6):548-50, 2006
                                          19. Tyler WK et al: Pigmented villonodular synovitis. J Am Acad Orthop Surg. 14(6):376-85, 2006
                                          20. Stubbs AJ et al: Pigmented villonodular synovitis of the knee: disease of the popliteus tendon and posterolateral compartment. Arthroscopy. 21(7):893, 2005
                                          21. Manaster BJ et al: Musculoskeletal Imaging: The Requisites. 2nd ed. Mosby, Elsevier, 2002
                                          Related Anatomy
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                                          Related Differential Diagnoses
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                                          References
                                          Tables

                                          Tables

                                          KEY FACTS

                                          • Imaging

                                            • Top Differential Diagnoses

                                              • Clinical Issues

                                                TERMINOLOGY

                                                • Synonyms

                                                  • Formerly pigmented villonodular synovitis (PVNS)
                                                  • Benign synovioma; focal nodular synovitis

                                                • Definitions

                                                  • Low-grade fibrohistiocytic proliferation with hemosiderin deposits in synovial joints
                                                  • 2 subtypes
                                                    • Diffuse tenosynovial giant cell tumor (TSGCT)
                                                    • Localized TSGCT

                                                IMAGING

                                                • General Features

                                                  • Radiographic Findings

                                                    • CT Findings

                                                      • MR Findings

                                                        • Ultrasonographic Findings

                                                          • Nuclear Medicine Findings

                                                            • Imaging Recommendations

                                                              DIFFERENTIAL DIAGNOSIS

                                                                PATHOLOGY

                                                                • General Features

                                                                  • Gross Pathologic & Surgical Features

                                                                    • Microscopic Features

                                                                      CLINICAL ISSUES

                                                                      • Presentation

                                                                        • Demographics

                                                                          • Natural History & Prognosis

                                                                            • Treatment

                                                                              DIAGNOSTIC CHECKLIST

                                                                              • Consider

                                                                                • Image Interpretation Pearls

                                                                                  Selected References

                                                                                  1. Crim J et al: Limited usefulness of classic MR findings in the diagnosis of tenosynovial giant cell tumor. Skeletal Radiol. 50(8):1585-91, 2021
                                                                                  2. Finkelstein D et al: Differential diagnosis of T2 hypointense masses in musculoskeletal MRI. Skeletal Radiol. 50(10):1981-94, 2021
                                                                                  3. Ota T et al: Tumor location and type affect local recurrence and joint damage in tenosynovial giant cell tumor: a multi-center study. Sci Rep. 11(1):17384, 2021
                                                                                  4. Spierenburg G et al: Management of tenosynovial giant cell tumour of the foot and ankle. Bone Joint J. 103-B(4):788-94, 2021
                                                                                  5. Dundar A et al: Unusual manifestations of diffuse-type tenosynovial giant cell tumor in two patients: importance of radiologic-pathologic correlation. Skeletal Radiol. 49(3):483-9, 2020
                                                                                  6. Tap W: ENLIVEN study: Pexidartinib for tenosynovial giant cell tumor (TGCT). Future Oncol. 16(25):1875-8, 2020
                                                                                  7. Gouin F et al: Localized and diffuse forms of tenosynovial giant cell tumor (formerly giant cell tumor of the tendon sheath and pigmented villonodular synovitis). Orthop Traumatol Surg Res. 103(1S):S91-7, 2017
                                                                                  8. Mollon B et al: Combined arthroscopic and open synovectomy for diffuse pigmented villonodular synovitis of the knee. Knee Surg Sports Traumatol Arthrosc. 24(1):260-6, 2014
                                                                                  9. Verspoor FG et al: Long-term follow-up results of primary and recurrent pigmented villonodular synovitis. Rheumatology (Oxford). 53(11):2063-70, 2014
                                                                                  10. Aurégan JC et al: Primary arthroscopic synovectomy for pigmented villo-nodular synovitis of the knee: recurrence rate and functional outcomes after a mean follow-up of seven years. Orthop Traumatol Surg Res. 99(8):937-43, 2013
                                                                                  11. Botez P et al: Adult multifocal pigmented villonodular synovitis--clinical review. Int Orthop. 37(4):729-33, 2013
                                                                                  12. Colman MW et al: Does combined open and arthroscopic synovectomy for diffuse PVNS of the knee improve recurrence rates? Clin Orthop Relat Res. 471(3):883-90, 2013
                                                                                  13. Berger B et al: External beam radiotherapy as postoperative treatment of diffuse pigmented villonodular synovitis. Int J Radiat Oncol Biol Phys. 67(4):1130-4, 2007
                                                                                  14. Ward WG Sr et al: Diffuse pigmented villonodular synovitis: preliminary results with intralesional resection and p32 synoviorthesis. Clin Orthop Relat Res. 454:186-91, 2007
                                                                                  15. Wu CC et al: Two incision synovectomy and radiation treatment for diffuse pigmented villonodular synovitis of the knee with extra-articular component. Knee. 14(2):99-106, 2007
                                                                                  16. Chiari C et al: What affects the recurrence and clinical outcome of pigmented villonodular synovitis? Clin Orthop Relat Res. 450:172-8, 2006
                                                                                  17. Finis K et al: Analysis of pigmented villonodular synovitis with genome-wide complementary DNA microarray and tissue array technology reveals insight into potential novel therapeutic approaches. Arthritis Rheum. 54(3):1009-19, 2006
                                                                                  18. Mendenhall WM et al: Pigmented villonodular synovitis. Am J Clin Oncol. 29(6):548-50, 2006
                                                                                  19. Tyler WK et al: Pigmented villonodular synovitis. J Am Acad Orthop Surg. 14(6):376-85, 2006
                                                                                  20. Stubbs AJ et al: Pigmented villonodular synovitis of the knee: disease of the popliteus tendon and posterolateral compartment. Arthroscopy. 21(7):893, 2005
                                                                                  21. Manaster BJ et al: Musculoskeletal Imaging: The Requisites. 2nd ed. Mosby, Elsevier, 2002