EURORAD ESR

Case 15087

A rare case of wrist diffuse type of tenosynovial giant cell tumour

Author(s)
Chong WH1, Li OC1, Lam MY2, Chan YF2, Yuen MK1

(1) Department of Radiology
(2) Department of Orthopaedics & Traumatology
Tuen Mun Hospital, HKSAR
852 Hong Kong
Email:cwh690@gmail.com
 
Patient
male, 66 year(s)
 
 
  • Figure 1
    XR - articular erosion of distal ulna and DRUJ

    Plain radiograph shows articular erosion of distal ulna and distal radioulnar joint.

     
    Area of Interest: Musculoskeletal joint; Imaging Technique: Plain radiographic studies; Procedure: Diagnostic procedure; Special Focus: Pathology;
     
     
  • Figure 2
    USG - soft tissue with increased vascularity and tendon encasement

    Heterogeneous hypoechoic soft tissue with increased vascularity in Doppler study, showing encasement of extensor tendons.

     
    Area of Interest: Musculoskeletal joint; Imaging Technique: Ultrasound-Colour Doppler; Procedure: Diagnostic procedure; Special Focus: Pathology;
     
     
  • Figure 3
    T1W MRI - ulnocarpal joint and tendon involvement

    T1-weighted intermediate signal involving the ulnocarpal joint with encasement of adjacent extensor tendon dorsally.

     
    Area of Interest: Musculoskeletal joint; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Pathology;
     
     
  • Figure 4
    T2W MRI - erosion and joint fluid with haemosiderin

    T2-weighted hyperintense joint fluid with haemosiderin deposit. (white open arrow) and erosion of distal radioulnar joint (white solid arrow)

     
    Area of Interest: Musculoskeletal joint; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Pathology;
     
     
  • Figure 5
    PVNS Intra-operative photo

    Intra-operative photo revealing dark intra-articular soft tissue (arrow), which is a classical finding in diffuse type of tenosynovial giant cell tumour (PVNS).

     
    Area of Interest: Musculoskeletal joint; Imaging Technique: Image manipulation / Reconstruction; Procedure: Diagnostic procedure; Special Focus: Pathology;
     
     
  • Figure 6
    PVNS histology

    Histology shows both villous change and haemosiderin-laden macrophages, suggestive of a diffuse type of tenosynovial giant cell tumour (PVNS).

     
    Area of Interest: Musculoskeletal joint; Imaging Technique: Image manipulation / Reconstruction; Procedure: Diagnostic procedure; Special Focus: Pathology;
     
     
Plain radiograph shows articular erosion of distal ulna and distal radioulnar joint.
 
Heterogeneous hypoechoic soft tissue with increased vascularity in Doppler study, showing encasement of extensor tendons.
 
T1-weighted intermediate signal involving the ulnocarpal joint with encasement of adjacent extensor tendon dorsally.
 
T2-weighted hyperintense joint fluid with haemosiderin deposit. (white open arrow) and erosion of distal radioulnar joint (white solid arrow)
 
Intra-operative photo revealing dark intra-articular soft tissue (arrow), which is a classical finding in diffuse type of tenosynovial giant cell tumour (PVNS).
 
Histology shows both villous change and haemosiderin-laden macrophages, suggestive of a diffuse type of tenosynovial giant cell tumour (PVNS).
 
 
 
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