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Adult multifocal pigmented villonodular synovitis--clinical review

Paul Botez1, Paul Dan Sirbu, Carmen Grierosu

  • 1Rehabilitation Hospital Iasi, Orthopaedic Surgery, Gr. T. Popa, University of Medicine and Pharmacy, Iasi, Romania.

International Orthopaedics
|January 31, 2013
PubMed

Insights

Multifocal pigmented villonodular synovitis (PVNS) is a rare condition affecting multiple joints. Early diagnosis and radical treatment, including surgery and joint replacement, are crucial for good functional recovery.

Area of Science:

  • Orthopedics
  • Rheumatology
  • Pathology

Background:

  • Pigmented villonodular synovitis (PVNS) is a rare, benign proliferative disease of the synovial tissue.
  • It typically affects a single joint or tendon sheath, with multifocal presentations being exceptionally rare in adults.
  • Delayed diagnosis can lead to severe joint degeneration, complications, and significant mobility impairment.

Purpose of the Study:

  • To present a case of multifocal pigmented villonodular synovitis (PVNS) in an adult patient.
  • To highlight the diagnostic challenges and treatment outcomes for this rare condition.
  • To emphasize the importance of timely and radical intervention.

Main Methods:

  • Review of literature on multifocal PVNS.
  • Clinical presentation and diagnostic workup of the adult patient.
  • Surgical intervention and histopathological confirmation.
  • Postoperative assessment of functional recovery.

Main Results:

  • The study presents a case of multifocal PVNS affecting bilateral shoulders, hips, and knees.
  • Diagnostic imaging (X-rays, MRI, ultrasound) and surgical findings confirmed the condition and secondary bone lesions.
  • Histology provided the definitive diagnosis of multifocal PVNS.
  • Postoperative prosthetic arthroplasty and synovectomy resulted in good functional recovery.

Conclusions:

  • Multifocal PVNS in adults, though rare, can affect multiple large joints.
  • A high index of suspicion and comprehensive imaging are necessary for early diagnosis.
  • Radical surgical treatment, including synovectomy and prosthetic arthroplasty, leads to favorable functional outcomes.

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