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Pigmented Villonodular Synovitis (PVNS), Sports Medicine

Nancy White, MD and Fouad Sayde, MD, ABIM, FACP Reviewed 04/2019
 


BASICS

DESCRIPTION

  • Pigmented villonodular synovitis (PVNS) is a proliferative disorder of the synovium.

  • There are two forms described, localized and diffuse, which are likely both ends of a spectrum of ...

DIAGNOSIS

HISTORY

  • Insidious onset

  • History of associated trauma is unusual.

  • Symptoms are often vague, may be intermittent, and are typically slowly progressive.

  • Swelling and stiffness out of proportion to ...

TREATMENT

  • Surgery is treatment of choice.

  • Localized PVNS: Arthroscopic partial synovectomy of lesion with margin of healthy synovium is recommended 2,3[A]:

    • Lesions in anterior compartment allow for surg...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • No clear-cut guidelines

  • Recurrence is common especially with diffuse PVNS.

  • Consider monitoring with MRI.

COMPLICATIONS

  • Recurrence

  • Joint erosion

  • End-st...

REFERENCES

1
Botez P, Sirbu PD, Grierosu C, et al. Adult multifocal pigmented villonodular synovitis—clinical review. Int Orthop.  2013;37(4):729–733.
2
Verspoor FG, Zee AA, Hannink G, et al. Long-t...

ADDITIONAL READING

  • Rodriguez-Merchan EC. Review article: open versus arthroscopic synovectomy for pigmented villonodular synovitis of the knee. J Orthop Surg (Hong Kong).  2014;22(3):406–408.

  • Tyle...

CLINICAL PEARLS

  • Insidious onset, not usually associated with trauma

  • Symptoms can be vague with swelling and stiffness out of proportion to pain.

  • Aspirate may be blood-tinged and show hemosiderin pigment...

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