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Logo of arthresbiomed central web sitesearch.manuscript submission.see also journal with issn 1478-6354registration.reference to the article.journal front page.
 
Arthritis Res. 2001; 3(Suppl A): P117.
Published online 2001 January 26. doi:  10.1186/ar286
PMCID: PMC3273205
Diagnostic value of synovial fluid analysis in pigmented villonodular synovitis (PVS)- a proposal of diagnostic criteria
I Zimmermann-Górska,1 M Puszczewicz,1 and G Bialkowska-Puszczewicz1
1Department of Rheumatology and Rehabilitation, Karol Marcinkowski, University of Medical Sciences, Poznañ, Poland
Supplement
21st European Workshop for Rheumatology Research
Conference
21st European Workshop for Rheumatology Research
1-4 March 2001
Vienna, Austria
Received January 15, 2001
 
PVS is an idiopathic lesion that affects the synovial joints,tendons,sheats and bursea through the production of tumour-like growths. Diagnosis of PVS is difficult. Arthroscopy and biopsy together with microscopic examination are usually a base. According to our experience, cytologic features of synovial fluid are a very useful diagnostic tool in PVS.
Material and methods
Synovial fluids (SF) from the joints of 14 patients with biopsy-proven PVS were examined. Moreover in all the patients features of the disease were confirmed in surgical specimes. Synovial fluids were divided into three samples, for physicochemical analysis, bacteriological and cytologic findings, and placed in sterile tubes. For cytological examination MGG staining was used.
Results
SF analysis had revealed an inflammatory character of effusion. In all the cases synovial fluids were bloody and fragments of synovial villi in their sediments were observed as well as multinucleated giant cells, pseudomalignant cell, macrophages with phagocytized hemosiderin, foam cell and a few synoviocytes. Moreover the fat crystals were seen, under polarized light.
Conclusion
Cytological features of synovial fluid in PVS are in parallel with results of microscopic examination of joints tissues. In our opinion SF analysis should be the first step in the diagnopstic procedure in PVS. We propose the following criteria:
Major
1. the presence of bloody fluid with fragments of synovial villi in sediment
2. macrophages containing hemosiderin
3. pseudomalignant cells
Minor
1. multinucleated giant cells
2. foam cells
3. fat crystals
The diagnosis of PVS can be establish if all the major and at least one of the minor criteria are fulfilled.
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