Pigmented Villonodular Synovitis of The Knee Joint: Diagnosis, Management and Summary of Tenosynovial Giant Cell Tumors: A Rare Case Report

Abstract

Introduction: Pigmented villonodular synovitis (PVNS) is a rare, benign, but potentially locally aggressive and recurrent condition characterized by synovial proliferation and hemosiderin deposition inside the joints, tendon sheaths, and bursae. It usually affects the large joints such as hip, knee, and ankle. Localised pigmented villonodular synovitis {PVNS} of the knee is rare diagnosis, with clinical signs and symptoms mimicking meniscal damage or other common knee injuries. 

Case Presentation: We report a case of PVNS of the knee joint in a 39-year-old female which was treated by arthroscopic subtotal synovectomy as a first stage surgery after which patient was planned for total synovectomy and postoperative radiotherapy. This case highlights the clinical presentation of this rare disorder and emphasizes its consideration as a differential diagnosis in our setup when dealing with non-traumatic persistent knee pain and swelling.

Conclusion: Pigmented villonodular synovitis demonstrates a locally destructive process but is rarely fatal. PVNS is primarily a disease of quality of life as it can lead to difficulty with activities of daily living and an overall decrease in quality of life. The clinical presentation of one case found in our region is described. Patients usually present with insidious onset joint swelling associated with pain that mimics joint effusion. Joint pain subsequently supervenes, but the swelling is disproportionate to the degree of pain. The pain is mild and of insidious onset, and it progressively worsens and frequently is accompanied by decreased range of motion and sometimes locking of the joint. We recommend that PVNS should be included as a differential diagnosis when evaluating a young adult with non-traumatic persistent knee pain and swelling