대한근골격영상의학회

Title : Case 456

Age / Sex : 32 / M Chief complaint : Neck pain What is your impression? Two weeks later, you can see the final diagnosis with a brief discussion of this case. (Please submit only one answer) Courtesy : Sang-Hee Choi, Samsung medical center Diagnosis: Pigmented villonodular synovitis of the spine Discussion Answer: pigmented villonodular synovitis of the spine Findings: Bone destruction centered on right C1-2 facet joint Isodensity to muscle on CT Mass with low signal intensity on both T1- and T2-weighted MRI Differential Diagnosis: • Malignant space-occupying lesions – e.g. metastasis, myeloma, and malignant peripheral nerve sheath tumors • Benign or borderline lesions – e.g. osteoblastoma, giant cell tumor of the bone, and synovial cyst formation with synovial hyperplasia Diagnosis: pigmented villonodular synovitis of the spine Discussion: 1) MR Findings Lesion showing low signal intensity on both T1- and T2-WI with heterogeneous enhancement after contrast adminstration References: Skeletal Radiol 2005; 34:185–195 J Neurosurg Spine 2007;7:248–253 J Comput Assist Tomogr 2015;39: 601–606

Title : Case 456

Age / Sex : 32 / M

Chief complaint : Neck pain

What is your impression?

Two weeks later, you can see the final diagnosis with a brief discussion of this case. (Please submit only one answer)

Courtesy : Sang-Hee Choi, Samsung medical center

Diagnosis:

Pigmented villonodular synovitis of the spine

Answer: pigmented
villonodular synovitis of the spine

Findings:

Bone destruction centered on right C1-2 facet joint

Isodensity to muscle on CT

Mass with low signal intensity on both T1- and T2-weighted
MRI

Differential Diagnosis:

• Malignant space-occupying lesions

– e.g. metastasis, myeloma, and
malignant peripheral nerve sheath tumors

• Benign or borderline lesions

– e.g. osteoblastoma, giant cell tumor
of the bone, and synovial cyst formation with synovial hyperplasia

Diagnosis:

pigmented
villonodular synovitis of the spine

Discussion:

1) MR Findings

Lesion
showing low signal intensity on both T1- and T2-WI with heterogeneous
enhancement after contrast adminstration

References:

Skeletal
Radiol 2005; 34:185–195

J Neurosurg
Spine 2007;7:248–253

J Comput
Assist Tomogr 2015;39: 601–606

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