Bilateral pigmented villonodular synovitis of the wrists

The wrist is an unusual anatomic location for pigmented villonodular synovitis (PVNS). PVNS is generally a benign or minimally destructive process, but in our patient it resulted in progressive erosive changes in a bilateral wrist distribution. This is the first histologically documented case of bilateral PVNS in this anatomic distribution, to our knowledge. Although uncommon, PVNS should be considered a possible cause of unexplained upper extremity inflammatory arthritis.