case_images: PMC8802824_01
case_images: MRI T1 Fat Sat sequences - right knee in coronal plane (A) and right knee in sagittal plane (B): diffuse synovial pannus, especially in the superior recess of the joint. Tri-compartmental chondropathy associating stage IV chondrolysis associated with multiple subchondral cysts; STIR sequence of the right elbow in sagittal plane (C): anterior intra-articular synovial masses in heterogeneous signal; T1 sequence after gadolinium injection of left ankle in sagittal plane (D): Large synovial panuses mainly affecting the subtalar joint and voluminous synovial masses developed around the long plantar flexor hallucis behind the lower end of the tibia. These signs were highly suggestive of multifocal villonodular synovitis which was later confirmed by histopathological examination.
case_images: fmed-08-817873-g0001.jpg
case_images: PMC8802824_01_fmed-08-817873-g0001.jpg
case_images: F1
case_images: This DMVS was then managed by surgical synovectomies with a double approach on each of the four joints (Figure 1).
case_images: Plain x-ray of the knees. Pancompartmental joint space loss reflecting secondary osteoarthritis changes, with presence of diffuse joint narrowing and subchondral cysts.
case_images: fmed-08-817873-g0002.jpg
case_images: PMC8802824_01_fmed-08-817873-g0002.jpg
case_images: F2
case_images: However, the radiographs show tricompartmental space loss, so that total knee prosthesis will probably be considered in the future (Figure 2).