0:01

<v ->Okay, so already had

0:04

three surgery.

0:05

This was the third, after the third surgery

0:10

in five years, okay?

0:13

So show it the extensive.

0:21

We did the diffusion sequence.

0:22

We're starting to do diffusion for bone tumors

0:25

and the diffusion does not show any brightness here.

0:32

So we have now progressive OA, osteoarthrosis

0:38

the secondary to the PVNS.

0:41

We have three surgeries.

0:43

And we also have, let me show you here.

0:47

The patient had to do an amputation.

0:49

Can you believe it?

0:53

This is the knee of that patient

0:55

with all the involvement.

1:00

So one of the worst case,

1:02

it's a benign lesion but with a lot of aggressiveness.

1:07

So sometimes in extreme case,

1:11

it will go to amputation.

1:12

This patient evoluted so rapidly, so that.

1:19

And then, you wanna do a comment on that, Doc?

1:22

<v ->Well I just want you to know

1:24

I indicated there were rare reports

1:26

of malignant changes with a PVNS

1:30

but I guess in that case,

1:31

they studied the tumor completely histologically

1:35

and it was entirely benign.

1:38

The other point is I think the value

1:41

of gradient echo imaging and picking up hemosiderin.

1:45

You know and a lot of times these scout images

1:47

are the ones that might show the hemosiderin deposition

1:51

and the other images do not.

1:54

So I think that's really valuable.