Diffuse pigmented villonodular synovitis in a college football player

In retrospect, it is evident that our patient had signs of PVS on initial presentation: suprapatellar pouch effusion and swelling out of proportion to discomfort. In addition, his first MRI scan showed characteristics of PVS: thickening and enhancement. Difficulty in reaching the diagnosis of PVS was aided by his asymptomatic return to football. Further confusing the issue, his initial presentation was directly associated with trauma, which is not pathognomonic for PVS. In conclusion, diffuse pigmented villonodular synovitis can be recognized early on MRI scans, which should be carefully examined, especially in the presence of large suprapatellar effusions. Diffuse PVS can be successfully treated with arthroscopic subtotal synovectomy.