Pigmented villonodular synovitis of the temporomandibular joint: MR findings in four cases

Objective: Although it is a rare condition, pigmented villonodular synovitis (PVNS) may involve temporomandibular joint (TMJ). The purpose of this study was to describe magnetic resonance (MR) findings of PVNS of the TMJ. Methods and material: Between April 1992 and August 2000, four patients (two men and two women, 22-58-year-old) who had histologically proven diagnoses of PVNS in their TMJ were found in our institution. Their MR findings were reviewed retrospectively, and were correlated with pathologic findings. Results: In all four patients, MR images invariably showed profound hypointensity on both T1- and T2-weighted sequences. This finding was seen diffusely and homogeneously throughout the lesion, and was considered to be due to paramagnetic effect attributed to heavy hemosiderin pigmentation, which was revealed by histopathological examination. MR images also showed aggressive nature of the lesions with adjacent skull base destruction and intracranial extension in two of them. Conclusion: As is the case in the other anatomic site, PVNS of the TMJ can be confidently diagnosed on MR imaging on the basis of the presence of hemosiderin. MR imaging also plays a pivotal role in surgical planning by precise and detailed localization of the lesion. (C) 2003 Elsevier Ireland Ltd. All rights reserved.