Synovial Disorders of the Hip

Living reference work entry

Abstract

The hip is a synovial joint which links the axial skeleton to that of the lower extremity by the articulation of the femur and acetabulum. The tissue of the synovium which lines the joint has the important role of regulation of synovial fluid production but also can be a source of significant but rare pathology. These disorders include synovial chondromatosis and pigmented villonodular synovitis (PVNS). Synovial chondromatosis will typically present with monoarticular pain and stiffness with mechanical complaints of locking and catching during the third to fifth decade of life due to the generation of loose bodies. Pigmented villonodular synovitis is another benign proliferative disorder of the synovium. While the lesion is benign, it can be locally aggressive and cause the destruction of both intra- and extra-articular structures in the third and fourth decades of life. Both disorders are treated with arthroscopic or open debridement with synovectomy. Synovial disorders of the hip are fortunately very rare but can be devastating. Surgical treatment, when undertaken in a timely fashion, can be effective at preserving hip function.

References

  1. 1.
    Iwanaga T, et al. Morphology and functional roles of synoviocytes in the joint. Arch Histol Cytol. 2000;63(1):17–31.PubMedCrossRefGoogle Scholar
  2. 2.
    Barland P, Novikoff AB, Hamerman D. Electron microscopy of the human synovial membrane. J Cell Biol. 1962;14:207–20.PubMedCentralPubMedCrossRefGoogle Scholar
  3. 3.
    Maurice H, Crone M, Watt I. Synovial chondromatosis. J Bone Joint Surg Br. 1988;70(5):807–11.PubMedGoogle Scholar
  4. 4.
    Apte SS, Athanasou NA. An immunohistological study of cartilage and synovium in primary synovial chondromatosis. J Pathol. 1992;166(3):277–81.PubMedCrossRefGoogle Scholar
  5. 5.
    Buddingh EP, et al. Chromosome 6 abnormalities are recurrent in synovial chondromatosis. Cancer Genet Cytogenet. 2003;140(1):18–22.PubMedCrossRefGoogle Scholar
  6. 6.
    Davis RI, et al. Cell proliferation studies in primary synovial chondromatosis. J Pathol. 1998;184(1):18–23.PubMedCrossRefGoogle Scholar
  7. 7.
    Villacin AB, Brigham LN, Bullough PG. Primary and secondary synovial chondrometaplasia: histopathologic and clinicoradiologic differences. Hum Pathol. 1979;10(4):439–51.PubMedCrossRefGoogle Scholar
  8. 8.
    Milgram JW. Synovial osteochondromatosis: a histopathological study of thirty cases. J Bone Joint Surg Am. 1977;59(6):792–801.PubMedGoogle Scholar
  9. 9.
    Murphy FD, Dahlin DC, Sullivan CR. Articular synovial chondromatosis. J Bone Joint Surg. 1962;44(1):77–86.Google Scholar
  10. 10.
    Kramer J, et al. MR appearance of idiopathic synovial osteochondromatosis. J Comput Assist Tomogr. 1993;17(5):772–6.PubMedCrossRefGoogle Scholar
  11. 11.
    Ogilvie-Harris DJ, Saleh K. Generalized synovial chondromatosis of the knee: a comparison of removal of the loose bodies alone with arthroscopic synovectomy. Arthroscopy. 1994;10(2):166–70.PubMedCrossRefGoogle Scholar
  12. 12.
    Schoeniger R, et al. Modified complete synovectomy prevents recurrence in synovial chondromatosis of the hip. Clin Orthop Relat Res. 2006;451:195–200.PubMedCrossRefGoogle Scholar
  13. 13.
    Gilbert SR, Lachiewicz PF. Primary synovial osteochondromatosis of the hip: report of two cases with long-term follow-up after synovectomy and a review of the literature. Am J Orthop (Belle Mead NJ). 1997;26(8):555–60.Google Scholar
  14. 14.
    Coles MJ, Tara Jr HH. Synovial chondromatosis: a case study and brief review. Am J Orthop (Belle Mead NJ). 1997;26(1):37–40.Google Scholar
  15. 15.
    Lim SJ, et al. Operative treatment of primary synovial osteochondromatosis of the hip. J Bone Joint Surg Am. 2006;88(11):2456–64.PubMedCrossRefGoogle Scholar
  16. 16.
    Boyer T, Dorfmann H. Arthroscopy in primary synovial chondromatosis of the hip: description and outcome of treatment. J Bone Joint Surg Br. 2008;90(3):314–8.PubMedCrossRefGoogle Scholar
  17. 17.
    Witwity T, Uhlmann RD, Fischer J. Arthroscopic management of chondromatosis of the hip joint. Arthroscopy. 1988;4(1):55–6.PubMedCrossRefGoogle Scholar
  18. 18.
    Krebs VE. The role of hip arthroscopy in the treatment of synovial disorders and loose bodies. Clin Orthop Relat Res. 2003;406:48–59.PubMedCrossRefGoogle Scholar
  19. 19.
    Lee JB, et al. Arthroscopic treatment of synovial chondromatosis of the hip. Am J Sports Med. 2012;40(6):1412–8.PubMedCrossRefGoogle Scholar
  20. 20.
    Hardacker J, Mindell ER. Synovial chondromatosis with secondary subluxation of the hip. A case report. J Bone Joint Surg Am. 1991;73(9):1405–7.PubMedGoogle Scholar
  21. 21.
    Sakellariou A, Johnstone DJ, Pringle JA. Synovial chondromatosis presenting as a pathological fracture of the femoral neck in an 89-year-old woman–a case report. Acta Orthop Scand. 1998;69(6):640–1.PubMedCrossRefGoogle Scholar
  22. 22.
    Campanacci DA, et al. Synovial chondrosarcoma of the hip: report of two cases and literature review. Chir Organi Mov. 2008;92(3):139–44.PubMedCrossRefGoogle Scholar
  23. 23.
    Ackerman D, et al. Results of total hip and total knee arthroplasties in patients with synovial chondromatosis. J Arthroplasty. 2008;23(3):395–400.PubMedCrossRefGoogle Scholar
  24. 24.
    Ligato A, Nelson S, Bengs BC. Hip resurfacing as treatment for synovial chondromatosis. Orthopedics. 2010;33(3).Google Scholar
  25. 25.
    Jaffe HL, Lichtenstein L, Sutro CJ. Pigmented villonodular synovitis, bursitis and tenosynovitis: a discussion of the synovial and bursal equivalents of the tenosynovial lesion commonly denoted as xanthoma, xanthogranuloma, giant cell tumor, or myeloplaxoma of the tendon sheath, with some considerations of this tendon sheath lesion itself. Arch Pathol. 1941;31:731–65.Google Scholar
  26. 26.
    Ma X, et al. Pigmented villonodular synovitis: a retrospective study of seventy five cases (eighty one joints). Int Orthop. 2013;37(6):1165–70.PubMedCentralPubMedCrossRefGoogle Scholar
  27. 27.
    Choong PF, et al. Pigmented villonodular synovitis. Monoclonality and metastasis–a case for neoplastic origin? Acta Orthop Scand. 1995;66(1):64–8.PubMedCrossRefGoogle Scholar
  28. 28.
    Sciot R, et al. Analysis of 35 cases of localized and diffuse tenosynovial giant cell tumor: a report from the Chromosomes and Morphology (CHAMP) study group. Mod Pathol. 1999;12(6):576–9.PubMedGoogle Scholar
  29. 29.
    Abdul-Karim FW, et al. Diffuse and localized tenosynovial giant cell tumor and pigmented villonodular synovitis: a clinicopathologic and flow cytometric DNA analysis. Hum Pathol. 1992;23(7):729–35.PubMedCrossRefGoogle Scholar
  30. 30.
    Mankin H, Trahan C, Hornicek F. Pigmented villonodular synovitis of joints. J Surg Oncol. 2011;103(5):386–9.PubMedCrossRefGoogle Scholar
  31. 31.
    Masih S, Antebi A. Imaging of pigmented villonodular synovitis. Semin Musculoskelet Radiol. 2003;7(3):205–16.PubMedCrossRefGoogle Scholar
  32. 32.
    Dorwart RH, et al. Pigmented villonodular synovitis of synovial joints: clinical, pathologic, and radiologic features. AJR Am J Roentgenol. 1984;143(4):877–85.PubMedCrossRefGoogle Scholar
  33. 33.
    Steinbach LS, et al. MRI of the knee in diffuse pigmented villonodular synovitis. Clin Imaging. 1989;13(4):305–16.PubMedCrossRefGoogle Scholar
  34. 34.
    Amber IB, Clark BJ, Greene GS. Pigmented villonodular synovitis: dedicated PET imaging findings. BMJ Case Rep. 2013Google Scholar
  35. 35.
    Vastel L, et al. Surgical treatment of pigmented villonodular synovitis of the hip. J Bone Joint Surg Am. 2005;87(5):1019–24.PubMedCrossRefGoogle Scholar
  36. 36.
    Chin KR, et al. Treatment of advanced primary and recurrent diffuse pigmented villonodular synovitis of the knee. J Bone Joint Surg Am. 2002;84-A(12):2192–202.PubMedGoogle Scholar
  37. 37.
    Shabat S, et al. The use of surgery and yttrium 90 in the management of extensive and diffuse pigmented villonodular synovitis of large joints. Rheumatology (Oxford). 2002;41(10):1113–8.CrossRefGoogle Scholar
  38. 38.
    O’Sullivan B, et al. Outcome following radiation treatment for high-risk pigmented villonodular synovitis. Int J Radiat Oncol Biol Phys. 1995;32(3):777–86.PubMedCrossRefGoogle Scholar
  39. 39.
    Gonzalez Della Valle A, et al. Pigmented villonodular synovitis of the hip: 2- to 23-year followup study. Clin Orthop Relat Res. 2001;388:187–99.PubMedCrossRefGoogle Scholar
  40. 40.
    Hoberg M, Amstutz HC. Metal-on-metal hip resurfacing in patients with pigmented villonodular synovitis: a report of two cases. Orthopedics. 2010;33(1):50.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  1. 1.Department of OrthopedicsState University of New YorkBuffaloUSA

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