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Pigmented Villonodular Synovitis (PVNS)
B.J. Manaster, MD, PhD, FACR
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KEY FACTS

  • Imaging

    • Top Differential Diagnoses

      • Clinical Issues

        • Diagnostic Checklist

          TERMINOLOGY

          • Synonyms

            • Pigmented villonodular synovitis (PVNS); benign synovioma; nodular tenosynovitis
            • Giant cell tumor of tendon sheath: Pathologically identical but fully discussed in separate section
          • Definitions

            • Monoarticular proliferation of hemorrhagic synovium
            • Occurs in joint, bursa, tendon sheath
              • PVNS: Diffuse, articular form
              • Giant cell tumor of tendon sheath: Localized, extraarticular form

          IMAGING

          • General Features

            • Imaging Recommendations

              • Radiographic Findings

                • CT Findings

                  • MR Findings

                    DIFFERENTIAL DIAGNOSIS

                      PATHOLOGY

                      • General Features

                        • Gross Pathologic & Surgical Features

                          • Microscopic Features

                            CLINICAL ISSUES

                            • Presentation

                              • Demographics

                                • Natural History & Prognosis

                                  • Treatment

                                    DIAGNOSTIC CHECKLIST

                                    • Consider

                                      • Image Interpretation Pearls

                                        Selected References

                                        1. Mollon B et al: Combined arthroscopic and open synovectomy for diffuse pigmented villonodular synovitis of the knee. Knee Surg Sports Traumatol Arthrosc. 24(1):260-6, 2014
                                        2. Verspoor FG et al: Long-term follow-up results of primary and recurrent pigmented villonodular synovitis. Rheumatology (Oxford). 53(11):2063-70, 2014
                                        3. Aurégan JC et al: Primary arthroscopic synovectomy for pigmented villo-nodular synovitis of the knee: recurrence rate and functional outcomes after a mean follow-up of seven years. Orthop Traumatol Surg Res. 99(8):937-43, 2013
                                        4. Botez P et al: Adult multifocal pigmented villonodular synovitis--clinical review. Int Orthop. 37(4):729-33, 2013
                                        5. Colman MW et al: Does combined open and arthroscopic synovectomy for diffuse PVNS of the knee improve recurrence rates? Clin Orthop Relat Res. 471(3):883-90, 2013
                                        6. Berger B et al: External beam radiotherapy as postoperative treatment of diffuse pigmented villonodular synovitis. Int J Radiat Oncol Biol Phys. 67(4):1130-4, 2007
                                        7. Ward WG Sr et al: Diffuse pigmented villonodular synovitis: preliminary results with intralesional resection and p32 synoviorthesis. Clin Orthop Relat Res. 454:186-91, 2007
                                        8. Wu CC et al: Two incision synovectomy and radiation treatment for diffuse pigmented villonodular synovitis of the knee with extra-articular component. Knee. 14(2):99-106, 2007
                                        9. Chiari C et al: What affects the recurrence and clinical outcome of pigmented villonodular synovitis? Clin Orthop Relat Res. 450:172-8, 2006
                                        10. Finis K et al: Analysis of pigmented villonodular synovitis with genome-wide complementary DNA microarray and tissue array technology reveals insight into potential novel therapeutic approaches. Arthritis Rheum. 54(3):1009-19, 2006
                                        11. Mendenhall WM et al: Pigmented villonodular synovitis. Am J Clin Oncol. 29(6):548-50, 2006
                                        12. Tyler WK et al: Pigmented villonodular synovitis. J Am Acad Orthop Surg. 14(6):376-85, 2006
                                        13. Stubbs AJ et al: Pigmented villonodular synovitis of the knee: disease of the popliteus tendon and posterolateral compartment. Arthroscopy. 21(7):893, 2005
                                        14. Manaster BJ et al: Musculoskeletal Imaging: The Requisites. 2nd ed. Philadelphia: Mosby, Elsevier, 2002
                                        Related Anatomy
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                                        Related Differential Diagnoses
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                                        References
                                        Tables

                                        Tables

                                        KEY FACTS

                                        • Imaging

                                          • Top Differential Diagnoses

                                            • Clinical Issues

                                              • Diagnostic Checklist

                                                TERMINOLOGY

                                                • Synonyms

                                                  • Pigmented villonodular synovitis (PVNS); benign synovioma; nodular tenosynovitis
                                                  • Giant cell tumor of tendon sheath: Pathologically identical but fully discussed in separate section
                                                • Definitions

                                                  • Monoarticular proliferation of hemorrhagic synovium
                                                  • Occurs in joint, bursa, tendon sheath
                                                    • PVNS: Diffuse, articular form
                                                    • Giant cell tumor of tendon sheath: Localized, extraarticular form

                                                IMAGING

                                                • General Features

                                                  • Imaging Recommendations

                                                    • Radiographic Findings

                                                      • CT Findings

                                                        • MR Findings

                                                          DIFFERENTIAL DIAGNOSIS

                                                            PATHOLOGY

                                                            • General Features

                                                              • Gross Pathologic & Surgical Features

                                                                • Microscopic Features

                                                                  CLINICAL ISSUES

                                                                  • Presentation

                                                                    • Demographics

                                                                      • Natural History & Prognosis

                                                                        • Treatment

                                                                          DIAGNOSTIC CHECKLIST

                                                                          • Consider

                                                                            • Image Interpretation Pearls

                                                                              Selected References

                                                                              1. Mollon B et al: Combined arthroscopic and open synovectomy for diffuse pigmented villonodular synovitis of the knee. Knee Surg Sports Traumatol Arthrosc. 24(1):260-6, 2014
                                                                              2. Verspoor FG et al: Long-term follow-up results of primary and recurrent pigmented villonodular synovitis. Rheumatology (Oxford). 53(11):2063-70, 2014
                                                                              3. Aurégan JC et al: Primary arthroscopic synovectomy for pigmented villo-nodular synovitis of the knee: recurrence rate and functional outcomes after a mean follow-up of seven years. Orthop Traumatol Surg Res. 99(8):937-43, 2013
                                                                              4. Botez P et al: Adult multifocal pigmented villonodular synovitis--clinical review. Int Orthop. 37(4):729-33, 2013
                                                                              5. Colman MW et al: Does combined open and arthroscopic synovectomy for diffuse PVNS of the knee improve recurrence rates? Clin Orthop Relat Res. 471(3):883-90, 2013
                                                                              6. Berger B et al: External beam radiotherapy as postoperative treatment of diffuse pigmented villonodular synovitis. Int J Radiat Oncol Biol Phys. 67(4):1130-4, 2007
                                                                              7. Ward WG Sr et al: Diffuse pigmented villonodular synovitis: preliminary results with intralesional resection and p32 synoviorthesis. Clin Orthop Relat Res. 454:186-91, 2007
                                                                              8. Wu CC et al: Two incision synovectomy and radiation treatment for diffuse pigmented villonodular synovitis of the knee with extra-articular component. Knee. 14(2):99-106, 2007
                                                                              9. Chiari C et al: What affects the recurrence and clinical outcome of pigmented villonodular synovitis? Clin Orthop Relat Res. 450:172-8, 2006
                                                                              10. Finis K et al: Analysis of pigmented villonodular synovitis with genome-wide complementary DNA microarray and tissue array technology reveals insight into potential novel therapeutic approaches. Arthritis Rheum. 54(3):1009-19, 2006
                                                                              11. Mendenhall WM et al: Pigmented villonodular synovitis. Am J Clin Oncol. 29(6):548-50, 2006
                                                                              12. Tyler WK et al: Pigmented villonodular synovitis. J Am Acad Orthop Surg. 14(6):376-85, 2006
                                                                              13. Stubbs AJ et al: Pigmented villonodular synovitis of the knee: disease of the popliteus tendon and posterolateral compartment. Arthroscopy. 21(7):893, 2005
                                                                              14. Manaster BJ et al: Musculoskeletal Imaging: The Requisites. 2nd ed. Philadelphia: Mosby, Elsevier, 2002