Pigmented Villonodular Synovitis of the Knee: An Underappreciated Source of Pain in Children and Adolescents

Abstract

Level IV.

Pigmented villonodular synovitis

“…the same value was 7-15 (mean 10.8 years) and 2-15 (mean 9.8 years) years, respectively. [234] In our series, there was a wide age range of 1-14 years, and three out of four cases were females. The most common symptoms of PVNS are pain and swelling in the affected joint; and localized tenderness, palpable soft tissue mass and stiffness can be observed.…”

“…have reported that 82% had swelling and 77% had pain in their 25 paediatric PVNS cases. [4] Mechanical complications such as meniscal injury and patellar dislocation is rarer in paediatric cases than in adults. In our four cases, all had joint swelling; three of them had pain, and one of them had a dislocated patella.…”

“…PVNS is usually monoarticular, and it usually involves the knee in paediatric cases. [234] Most of the children with polyarticular involvement have been reported to have other congenital problems, such as skin lesions, pulmonary stenosis, mental retardation, Noonan syndrome and fetal hydantoin syndrome suggesting a possible genetic basis for this disease. [234] All of our four cases had monoarticular knee joint involvement, and had no extra articular findings.…”

“…PVNS usually develops insidiously, and its diagnosis is often delayed. [234] In Baroni's and Neubauer's case series, average diagnostic delay period were 33 months and >1 year, respectively. [23] It is usually confused with JIA, haemophilic arthropaties and other malignant/infectious disorders in childhood.…”

“…[1] While most cases with PVNS are adult patients aged between 20-50 years, there are also small number of afflicted children reported. [234] The youngest case in literature is that of an 8-month-old child. [5]…”