Pigmented villonodular synovitis

Abstract

Background Pigmented villonodular synovitis (PVNS) is a rare benign condition characterized by villous or nodular hyperplasia of the synovium. Few Moroccan studies on this disease have been reported in the literature. The purpose of this study was to evaluate the clinical, radiographic, and pathologic features and outcomes of PVNS in seven patients. Methods This retrospective study examined data from seven patients with pathologically-confirmed PVNS. Patients were selected from the Rheumatology and Orthopaedic Surgery departments over a period of 2 years (January 2009–December 2010). Collected data included disease localization, therapeutic modalities, and outcomes. Results Five women and two men were included. The mean age was 30 years (20–50 years). The knee was involved in five patients, the elbow in one patient, and the hip in one patient. Mean duration of symptoms was 36 months (7 months–12 years). Clinical presentation included chronic pain, functional disability, and joint effusion. There was no inflammatory syndrome or coagulation disorder. Joint aspiration was performed in five patients. Radiographs revealed bone abnormalities in two patients. MRI was performed in all patients and showed images characteristic of PVNS. Synovial biopsy confirmed the diagnosis in all patients. All patients underwent surgical synovectomy with good functional results. None had synoviorthesis. Recurrence occurred in one patient 2 months after surgery. The mean follow-up time was 28±6 months. Conclusions The diagnosis of PVNS is purely histological. MRI allows early recognition and improves the early management of this pathology. Synovectomy should be as complete as possible to reduce the risk of recurrence.