Diffuse pigmented villonodular synovitis in knee joint: diagnosis and treatment

Abstract

Pigmented villonodular synovitis is a rare proliferative condition of the synovium. Although the condition can present in any joint, the knee is the most commonly affected site. Despite being a benign condition, pigmented villonodular synovitis is often aggressive, with marked extra-articular extension in some cases. Monoarticular involvement occurs in two forms: localized and diffuse. The latter is more common, with a high recurrence rate. There is no standard method of management of this lesion. Open surgery is a classical and effective method for treatment. Arthroscopic synovectomy, however, has gained popularity, and has several advantages over the open technique particularly in exclusively articular cases. The combined approach is suggested in cases with extra-articular involvement. Synovectomy through any approach may prevent secondary osteoarthritis and subsequent joint arthroplasty. Internal irradiation or external beam radiation as an adjuvant treatment to surgical synovectomy appears to decrease the rate of local recurrence in diffuse cases. The authors observed a great heterogeneity in reporting of functional results, and specific conclusions should not be drawn. Each patient should be managed in accordance with his/her particular condition.

Diagnóstico y tratamiento de la sinovitis vellonodular pigmentada de la rodilla

“…La escisión quirúrgica abierta ha sido el método principal. Otro método es la sinovectomía artroscópica, que tiene la ventaja de realizar incisiones más pequeñas y reducir la morbilidad, pero ha informado tasas de recurrencia de hasta el 46%, por lo que algunos autores recomiendan la sinovectomía abierta (15). También es teóricamente posible que la artroscopia dé como resultado una siembra secundaria debido a la visión quirúrgica limitada y al sistema de irrigación articular que probablemente conduzca a la recurrencia.…”

Localized Pigmented Villonodular Synovitis of the Posterior Knee Compartment with Popliteal Vessel Compression: A Case Report of Arthroscopic Resection Using Only Anterior Knee Portals

“…Pigmented villonodular synovitis is an uncommon disease with around two new cases per million individuals per year [ 1 ]. It has a benign proliferative nature and affects the synovium of a joint either diffusely or focally [ 8 ].…”

Case report: left atrial Myxoma causing elevated C-reactive protein, fatigue and fever, with literature review

“…The incidence of PVNS ranges around 1.8 per million, usually monoarticular, affecting large joints, with the knee being the most common site. Microscopically, the synovial membrane is characterized by inflammation and presence of hemosiderin deposits, lipid-laden macrophages, multinucleated giant cells and proliferation of fibroblasts and stromal cells [20].…”