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DOUBLE-CONTRAST ARTHROGRAPHY IN THE DIAGNOSIS OF PIGMENTED VILLONODULAR SYNOVITIS OF THE KNEE

RICHARD D. WOLFE USAF, MC1 and VINCENT J. GIULIANO USA, MC2

1 Assistant Chief, Diagnostic Radiology Department, Mount Zion Hospital and Medical Center, 1600 Divisadero Street, San Francisco, California.
2 Chief, General Medicine Service, Brooke Army Medical Center, Fort Sam Houston, Texas.

Two patients with a histologically proven diagnosis of pigmented villonodular synovitis of the knee are reported. This diagnosis should be considered and an arthrogram obtained when a young adult presents with chronic swelling and stiffness of a single joint with minimal if any pain and with bogginess of the synovium.

The condition is even further suspected when aspiration reveals a moderately large quantity of dark blood-containing effusion, and plain roentgenograms show a normal joint other than the effusion and occasionally some nodularity of the suprapatellar area.

When the double-contrast method is used, preoperative arthrography should result in a diagnosis, as was the case in the 2 patients reported.


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