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Pigmented villonodular synovitis (PVNS)

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

Giant cell tumours of the tendon sheath (GCTTS) (nodular tenosynovitis) and pigmented villonodular synovitis (PNVS) have long been studied

  • conditions are considered to be benign growths of round or polygonal histiocyte-like cells associated with multinucleated giant cells, foam cells, and hemosiderin-laden cells. Although these two conditions are considered related entities, there is a practical difference

  • Giant cell tumours of the tendon sheat (GCTTS)

    • most lesions of GCTTS produce one or more discrete nodules commonly on the tendon sheath or in the small joints of the fingers and toes

    • GCTTS (nodular tenosynovitis, localised pigmented villonodular synovitis) is a solitary benign soft-tissue tumour that most commonly occurs in the hand, with recurrence rates of 25 to 45% (1)
      • postoperative radiotherapy may reduce the recurrence rate to 4%

    • less common sites include large joints, such as the ankle or knee

  • pigmented villonodular synovitis (PNVS)
    • is identified by a diffusely proliferated synovial membrane bearing a villous aspect with or without nodular formation, and most frequently involves the knee joint (2)

      • is a rare, benign, proliferative lesion of synovial tissue

      • typically and most commonly occurs in the knee followed by the hip, ankle, elbow, and shoulder, and in patients who are relatively young (< 40 years)

      • although several surgical methods have been used for treatment of PVNS of the knee, including open and arthroscopic synovectomy, rates of recurrence are high (30-92%)
        • adequate synovectomy is very important to treat diffuse type of disease. Recently, recurrence rates have been reduced, because the extent of the lesion is accurately estimated by MRI preoperatively
        • arthroscopic treatment can be used for localized lesion
          • however it is almost impossible to resect all lesions in the diffuse type lesion because this disease sometimes expands to the extra-articular lesion


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