ABSTRACT
Pigmented villonodular synovitis (PVNS) is a benign but rare proliferative disorder of the synovium. It commonly occurs in the adult population and usually presents as a monoarticular disease. There are two types of PVNS, namely the localised and diffused type. The disease is often misdiagnosed due to its rarity especially in paediatric patients. Knee involvement in PVNS is the commonest form in children although other joints such as hip, foot, ankle, hip, sacroiliac joint and concurrent multiple joint involvements have also been reported. PVNS in paediatric patients is often misdiagnosed as septic arthritis, juvenile rheumatoid arthritis and bone sarcoma, and the diagnosis is usually often made late due to its vague presentation. The majority of PVNS cases are managed by surgery either via open or arthroscopic synovectomy except in a few paediatric patients as described in the literature. This case report of PVNS is of a knee in 11-year-old boy who was initially treated as septic arthritis. The synovium appearance mimicked the features of PVNS during a knee arthrotomy washout, and histopathological examination confirmed the diagnosis. The knee symptoms had significantly improved without additional surgery, and good functional knee motion was achieved, with no sign of recurrence, after two years of follow-up.
ABSTRACT
@#Pigmented villonodular synovitis (PVNS) is a benign but rare proliferative disorder of the synovium. It commonly occurs in the adult population and usually presents as a monoarticular disease. There are two types of PVNS, namely the localised and diffused type. The disease is often misdiagnosed due to its rarity especially in paediatric patients. Knee involvement in PVNS is the commonest form in children although other joints such as hip, foot, ankle, hip, sacroiliac joint and concurrent multiple joint involvements have also been reported. PVNS in paediatric patients is often misdiagnosed as septic arthritis, juvenile rheumatoid arthritis and bone sarcoma, and the diagnosis is usually often made late due to its vague presentation. The majority of PVNS cases are managed by surgery either via open or arthroscopic synovectomy except in a few paediatric patients as described in the literature. This case report of PVNS is of a knee in 11- year-old boy who was initially treated as septic arthritis. The synovium appearance mimicked the features of PVNS during a knee arthrotomy washout, and histopathological examination confirmed the diagnosis. The knee symptoms had significantly improved without additional surgery, and good functional knee motion was achieved, with no sign of recurrence, after two years of follow-up.
ABSTRACT
Mild cognitive impairment (MCI) is the transitional stage between normal aging and Alzheimer's disease (AD). Impairments in semantic memory have been demonstrated to be a critical factor in early AD. The Boston Naming Test (BNT) is a straightforward method of examining semantic or visuo-perceptual processing and therefore represents a potential diagnostic tool. The objective of this study was to examine naming ability and identify error types in patients with amnestic mild cognitive impairment (aMCI). METHODS: Twenty aMCI patients, twenty AD patients and twenty-one normal controls, matched by age, sex and education level were evaluated. As part of a further neuropsychological evaluation, all subjects performed the BNT. A comprehensive classification of error types was devised in order to compare performance and ascertain semantic or perceptual origin of errors. RESULTS: AD patients obtained significantly lower total scores on the BNT than aMCI patients and controls. aMCI patients did not obtain significant differences in total scores, but showed significantly higher semantic errors compared to controls. CONCLUSION: This study reveals that semantic processing is impaired during confrontation naming in aMCI.
Comprometimento cognitivo leve (CCL) é um estágio de transição entre o envelhecimento normal e a doença de Alzheimer (DA). Comprometimento da memória semântica tem sido demonstrado como um fator crítico na DA precoce. O Teste de Nomeação de Boston (TNB) é um meio fácil para examinar o processamento semântico e viso-espacial e também um instrumento potencial de diagnóstico. OBJETIVO: Examinar a habilidade de nomeação e discriminar os tipos de erros em pacientes com CCL amnéstico (CCLa). MÉTODOS: Vinte pacientes com CCLa, 20 pacientes com DA e 21 controles normais pareados por idade, sexo e nível educacional foram avaliados. Como parte da avaliação neuropsicológica a todos foi administrado o TNB. Uma ampla classificação dos tipos de erros foi realizada a fim de comparar o desempenho e conhecer a origem semântica ou perceptiva dos erros. RESULTADOS: Os pacientes com DA obtiveram piores escores totais no TNB do que os pacientes com CCLa e controles. Os pacientes com CCLa não tiveram diferenças significativas nos escores totais, porém, mostraram um número maior e significativo de erros semânticos comparados aos controles. CONCLUSÃO: Este estudo revela que o processamento semântico está comprometido durante a nomeação por confrontação no CCLa.
