Pigmented villonodular synovitis of the hip

Abstract

Pigmented villonodular synovitis (PVNS) is a rare disease that can affect any joint, bursa or tendon sheath.The hip is less frequently affected than the knee, and hence is less discussed in scientific journals.PVNS of the hip mainly occurs in young adults, requiring early diagnosis and adequate treatment to obtain good results.There is no consensus on the management of PVNS of the hip in current literature.We will discuss the options for surgical intervention in hip PVNS using a literature review of clinical, biological, etiological, histological and radiographic aspects of the disease.Cite this article: Steinmetz S, Rougemont A-L, Peter R. Pigmented villonodular synovitis of the hip. EFORT Open Rev 2016;1:260-266. DOI: 10.1302/2058-5241.1.000021.

Benign Tumor-Like Conditions of the Hip

“…15 It has an annual incidence in the United States of 1.8 per 1 million, with 15% of those affecting the hip joint. 16,17 The cause of PVNS is still unknown, with studies postulating trauma, chronic inflammatory etiology versus a neoplastic origin. 15,16,18,19 Classically, the disease occurs in those who are 20 to 40 years of age, although extreme outliers have been reported.…”

“…16,17 The cause of PVNS is still unknown, with studies postulating trauma, chronic inflammatory etiology versus a neoplastic origin. 15,16,18,19 Classically, the disease occurs in those who are 20 to 40 years of age, although extreme outliers have been reported. 15,16 Clinically, the most common presenting symptoms are pain and decreased range of motion.…”

“…15,16,18,19 Classically, the disease occurs in those who are 20 to 40 years of age, although extreme outliers have been reported. 15,16 Clinically, the most common presenting symptoms are pain and decreased range of motion. 19 PVNS of the hip is known to cause joint destruction via its diffuse intraarticular involvement that presents radiographically as lytic lesions and subchondral cysts about the entire hip joint.…”

“…Histologically, PVNS contains primarily mononuclear cells with a pale cytoplasm interspersed with multinucleated giant cells as well as foamy (lipid-laden) histiocytes in the setting of synovial hypertrophy. 16,19 PVNS can be delineated as either diffuse or nodular (localized) types, with the diffuse type being more common in the hip joint. 16 Treatment is dictated primarily by the degree of joint destruction, with the ultimate goal being to remove the afflicted synovium to stop joint destruction and local recurrence.…”

“…16,19 PVNS can be delineated as either diffuse or nodular (localized) types, with the diffuse type being more common in the hip joint. 16 Treatment is dictated primarily by the degree of joint destruction, with the ultimate goal being to remove the afflicted synovium to stop joint destruction and local recurrence. 16 Joint preservation should be attempted in the younger population, whereas arthroplasty is a viable alternative in those of an advanced age.…”