Pigmented Villonodular Synovitis (PVNS) is a medical condition that refers to the thickening of the synovial membrane. The membrane is a thin slippery layer of tissue that lines the cartilage and helps in lubrication as well as the smooth movement of the joints. The condition causes the synovium to secrete extra fluids which eventually leads to swelling and hinders the movement of the joint. The overgrowth of the tissues forms a tumor but is not cancerous. PVNS may affect one or more joints of the body and is most commonly observed in the knee, hip, elbow, ankle as well as the shoulder. People in the age group of 30-40 years are more susceptible to the disorder. Pigmented Villonodular Synovitis can be classified into two categories:
Localized – The tendons are affected by the growth of the tumor but it is localized to just one point within the joint
Diffused – The tumor spreads through the entire joint and may cause severe damage
Causes
PVNS is largely attributed to genetic anomalies and no other cause of this disease has been established so far.
Symptoms
- Swelling in the joint
- Catching or locking of the joint when moved
- The joint may feel unstable and weak
- Pain Stiffness
- Loss of motion or functionality
- The symptoms may occur periodically
Diagnosis
- X-ray imaging to check if the condition has cause damage to the bone
- Clinical examination of the symptoms, affected joint and range of motion
- Evaluation of patient’s medical and family history
- MRI scan may help to assess if the condition is localized or diffused as well as the severity of the thickened synovium
- Aspiration – Drainage of the fluid from the joint for clinical testing
- The doctor may extract a part of tissue from the tumor for biopsy
Treatment
- Most cases of Pigmented Villonodular Synovitis require surgical treatment. The following procedures may be recommended:
- Arthroscopy – A camera guided, minimally invasive procedure to remove the tumor
- Open surgery – An incision is made in the joint and the membrane is removed to prevent any damage to the joint. The procedure is mainly recommended for patients with diffused PVNS
- Combined arthroscopic and open surgery – If the majority of the tumor mass is located at the back of the joint, it is removed through open surgery while the remaining part at the front is extracted by arthroscopy.
- Total replacement of the joint may be required in severe cases. In this, the orthopedic surgeon removes the damaged part of the joint and replaces it with artificial implants.
