Medicina nuclear y radioterapia

Arthroscopic Surgery and Radiosynovectomy to the Hip Joint with Diffuse Pigmented Villonodular Synovitis

Abstract

Hasan Ikbal Atilgan, Murat Sadic, Hakan Ozsoy, Gokhan Koca and Meliha Korkmaz

A 32-year-old female patient admitted with right hip pain that was diagnosed of diffuse PVNS in right hip joint with magnetic resonance imaging. She went arthoscopic synovectomy for this lesion. Six weeks after the surgery, RS was applied. Before RS three phase bone scintigraphy was taken and minimal increased perfusion, minimal hyperemias were detected in right hip joint. On the late phase images relatively increased activity accumulation in right hip joint was seen. 3 mCi (111 MBq) yttrium-90 colloid was administered to the hip joint under fluoroscopy guidance. The Bremsstrahlung imaging was performed using a gamma camera equiped four hours after RS. In the six and nine months control after RS patient did not have any complaints. In nine months control, MRI and three phase bone scintigraphy were taken and no pathologic radioactivity accumulation on bone scan, any residual lesion or recurrence on MRI was present. To our best knowledge, this is the first case with arthroscopic surgery and adjuvant RS with Y-90 colloid which rarely applied in routine practice for treatment of diffuse PVNS of the hip.