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synonyms: PVNS
PVNS ICD-10
- M12.20 - Villonodular synovitis (pigmented), unspecified site
- M12.21 - Villonodular synovitis (pigmented), shoulder
- M12.211 - Villonodular synovitis (pigmented), right shoulder
- M12.212 - Villonodular synovitis (pigmented), left shoulder
- M12.219 - Villonodular synovitis (pigmented), unspecified shoulder
- M12.221 - Villonodular synovitis (pigmented), right elbow
- M12.222 - Villonodular synovitis (pigmented), left elbow
- M12.229 - Villonodular synovitis (pigmented), unspecified elbow
- M12.231 - Villonodular synovitis (pigmented), right wrist
- M12.232 - Villonodular synovitis (pigmented), left wrist
- M12.239 - Villonodular synovitis (pigmented), unspecified wrist
- M12.241 - Villonodular synovitis (pigmented), right hand
- M12.242 - Villonodular synovitis (pigmented), left hand
- M12.249 - Villonodular synovitis (pigmented), unspecified hand
- M12.251 - Villonodular synovitis (pigmented), right hip
- M12.252 - Villonodular synovitis (pigmented), left hip
- M12.259 - Villonodular synovitis (pigmented), unspecified hip
- M12.261 - Villonodular synovitis (pigmented), right knee
- M12.262 - Villonodular synovitis (pigmented), left knee
- M12.269 - Villonodular synovitis (pigmented), unspecified knee
- M12.271 - Villonodular synovitis (pigmented), right ankle and foot
- M12.272 - Villonodular synovitis (pigmented), left ankle and foot
- M12.279 - Villonodular synovitis (pigmented), unspecified ankle and foot
- M12.28 - Villonodular synovitis (pigmented), other specified site
- M12.29 - Villonodular synovitis (pigmented), multiple sites
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
- Localized:
- Diffuse:
- Treatment: total synovectomy (open or arthroscopic) (DePonti A, Arthroscopy 2003;19:602).
- Recurrence is common.
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
- (DePonti A, Arthroscopy 2003;19:602)°
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