Summary
Diffuse pigmented villonodular synovitis of the hip joint is uncommon. The disease is usually slowly progressive with accompanying pain and limitation of movement. Radiographs often show cystic radiolucent defects in the acetabulum and femoral head, but the joint space remains preserved until late. Two cases are reported, both with a primary diagnosis of coxarthrosis which had been treated unsuccessfully by intertrochanteric osteotomy. A correct diagnosis was not reached until the hip joint was explored. The progress of radiographic changes over a period of eight years is demonstrated in one case. Arthroscopy and synovial biopsy should be considered in young adults with hip pain of unknown origin.
Résumé
La synovite villo-nodulaire hémopigmentée de la hanche est rare. La maladie est habituellement lentement progressive, s'accompagnant de douleurs et de limitation des mouvements. Les radiographies montrent souvent des images géodiques du cotyle et de la tête fémorale mais l'interligne articulaire demeure longtemps normal. Deux cas sont rapportés ici, tous les deux ayant initialement été considérés comme des coxarthroses et traités sans succès par ostéotomie intertrochantérienne. Le diagnostic exact n'a été fait qu'à l'arthrotomie. Les modifications radiologiques survenues au cours des huit ans d'évolution sont présentées dans l'un de ces cas. On peut proposer une arthroscopie et une biopsie synoviale chez un sujet jeune en présence de douleurs de hanche d'origine inconnue.
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Rydholm, U. Pigmented villonodular synovitis of the hip joint. International Orthopaedics 11, 307–310 (1987). https://doi.org/10.1007/BF00271305
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DOI: https://doi.org/10.1007/BF00271305