Definition
Pigmented villonodular synovitis is now generally classified within tenosynovial giant cell tumour. It is a proliferative synovial disorder characterised by hemosiderin deposition and local joint destruction.
Types
- localised
- diffuse
The knee is the commonest joint involved.
Presentation
- recurrent atraumatic swelling
- pain and stiffness
- recurrent haemarthrosis
- mechanical symptoms in localised disease
Imaging
Plain radiographs
May be normal early. Later findings can include pressure erosions and degenerative change.
MRI
Typical findings include synovial proliferation with low signal from hemosiderin and susceptibility blooming on gradient-echo sequences.
Diagnosis
Diagnosis is based on imaging and histological confirmation where required.
Treatment
- localised disease: excision of the lesion
- diffuse disease: synovectomy, arthroscopic or open depending on distribution
- recurrent or unresectable disease may require specialist multidisciplinary treatment