What is Pigmented Villonodular Synovitis?

Pigmented villonodular synovitis (PVNS) can develop in two ways: local or diffuse. The former type develops in just one area, such as one-half of the joint. The diffuse type of PVNS can envelop the whole lining of the joint and cause extended difficulties, while the local type generally affects only the joint. Diffuse PVNS is more severe.

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It is easy to become worried that pigmented villonodular synovitis is a cancerous condition because the growth can resemble, and are referred to as, tumors, but it is not. The non-cancerous masses stay within the joint and do not cause fatalities.

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The doctor may refer to pigmented villonodular synovitis in various ways:

• PVNS - its initials.
• Tenosynovial giant-cell tumor
• Localized pigmented villonodular synovitis
• Diffuse pigmented villonodular synovitis

Pain and swelling are the most notable symptoms of pigmented villonodular synovitis. The swelling is often significant and can be noticeable. Some people say that their joints freeze up or become locked. Others report feeling unstable while walking or weight-bearing. The symptoms can come and go depending on activity levels. Diffuse PVNS differs in its presentation, and the symptoms may be less severe at first compared to local pigmented villonodular synovitis. Eventually, the symptoms become more prevalent as the former form of the disease progresses.

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The physician can diagnose pigmented villonodular synovitis in an examination or order radiological studies such as x-rays, MRIs, and even CT scans. If the imaging studies are unclear, the doctor may perform a joint aspiration, which involves using a small needle to withdraw the fluid and a tiny piece of tissue around the affected joint. The sample is sent the lab for further testing.

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Genetics and family history may be related to the development of pigmented villonodular synovitis, but experts have yet to confirm this. Some physicians suggest the disease is similar to arthritis because of where the tissues become inflamed and start to thicken in response to the inflammation. One Chinese study of 237 people discovered 53 percent of affected individuals had suffered trauma to the joints before being diagnosed with PVNS.

Research discovered women have a 25 percent greater chance of having this disease, which could be linked to the tendency of women to experience more arthritic symptoms than men. Women have wider hips, which can lead to misalignment of the knees. This can put more strain on the joints, leading to increased inflammation. Hormones in women also play a large role in the stability of joints; some studies show that after menopause, women have an increased risk for arthritis because of a decrease in estrogen levels.

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Any joint can be affected by PVNS, including the jaw, but typically the condition affects larger and more active areas, especially the hips and knees. These joints receive the most daily use and are at the highest risk for injury. Running, bending, using stairs, and even squatting down to pick up large items can create a lot of strain on the hips and knees. The more trauma a person has in these joints, the higher their risk of developing PVNS.

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Pigmented villonodular synovitis does not solely affect older adults, despite its possible link to arthritis. The condition, in fact, appears to be most prevalent in people in their thirties and forties. However, the condition can also affect children and older individuals.

Surgery to remove the tumor is the first step in treating PVNS. The disease is aggressive, so surgeons often employ arthroscopic synovectomy, which allows them to visualize the joint with cameras through small incisions. Additionally, tools used in conjunction with the video device allows surgeons to remove problematic tissue at the same time. After the surgery, doctors may recommend radiation therapy to help destroy the cells causing the growths. Other treatments for PVNS include physical therapy and joint replacement surgery if the condition is recurring

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