Pigmented villonodular synovitis

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[edit] Discussion of Pigmented villonodular synovitis

  • Pigmented Villonodular Synovitis (PVNS) is a benign proliferative disorder of the synovium that may affect the joints, bursae, or tendon sheaths.
  • It can appear in either a diffuse or, less commonly, a focal form within the joint.
  • PVNS most often occurs in young to middle-aged adults.
  • The knee is the most frequently involved joint, followed by the hip, ankle, and shoulder.
  • Polyarticular involvement is extremely rare.
  • Local recurrence following surgical or arthroscopic synovectomy occurs in almost 50% of case.

[edit] Imaging Findings for Pigmented villonodular synovitis

  • Conventional radiographs of joints affected by PVNS may appear normal or may demonstrate periarticular soft-tissue swelling. Joint spaces and bone mineralization are characteristically preserved until late in the disease. Bone erosions are common in joints with a tight capsule, such as the hip and ankle.


  • On MR images, the masslike proliferative synovium has a lobulated margin, and it may be extensive in diffuse PVNS or limited to a single nodule in the focal form.
  • The lesions tend to bleed, causing hemosiderin deposition and a characteristic blooming on gradient echo imaging.
  • Areas of high signal intensity on T2-weighted images may be present and are likely caused by inflamed synovium or joint effusions.

[edit] Images

Patient #1: MR images demonstrate PVNS

Patient #2: Right shoulder radiographs demonstrate erosions from PVNS

[edit] See Also

[edit] External Links

[edit] References for Pigmented villonodular synovitis