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Pigmented Villonodular Synovitis
synonyms: PVNS
PVNS ICD-9
- 719.20 (villonodular synovitis: site unspecified)
- 719.21 (villonodular synovitis: shoulder region)
- 719.22 (villonodular synovitis: upper arm)
- 719.23 (villonodular synovitis: forearm)
- 719.24 (villonodular synovitis: hand)
- 719.25 (villonodular synovitis: pelvic region and thigh)
- 719.26 (villonodular synovitis: lower leg)
- 719.27 (villonodular synovitis: ankle and foot)
- 719.28 (villonodular synovitis: other specified sites)
- 719.29 (villonodular synovitis: multiple sites)
PVNS Etiology / Epidemiology / Natural History
- Uncommon proliferative disorder of they synovium.
- May be a neoplastic disorder with reactive synovitis.
- Etiology unknown.
- Generally 3rd - 4th decades. Can occur at any age.
PVNS Anatomy
PVNS Clinical Evaluation
PVNS Xray / Diagnositc Tests
- MRI: T1 images show predominantly low signal intensiti. T2 images show low to intermediate signal. Intra-articular nodular masses; modest vascularity on gadoliunium images; "blooming" on gradient echo images (ferrous-laden tissue)
- Diagnosis is confirmed by biopsy.
PVNS Classification / Treatment
PVNS Associated Injuries / Differential Diagnosis
- Hoffa's disease
- Post traumatic inflammation
- Patellar fat pad fibrosis
- Chondroma
PVNS of the Knee Arthroscopic synovectomy Complications
- Recurrence
- Iatrogenic chondral injury
- Hemarthrosis / hematoma
- DVT: 9.9%, proximal DVT rate = 2.1% (Ilahi OA, Arthroscopy, 2005;21:727)
- Stiffness / Arthrofibrosis
- Arthritis
- Infection
- NVI (saphenous neuralgia)
- Fluid Extravastion / Compartment Syndrome
- Complex Regional Pain Syndrome: rare
- Synovial fistula
PVNS Follow-up Care
- WBAT with crutches as needed. Home ROM and strengthening program.
PVNS Review References
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