The Full Wiki

More info on Pigmented villonodular synovitis

Pigmented villonodular synovitis: Wikis

Advertisements

Note: Many of our articles have direct quotes from sources you can cite, within the Wikipedia article! This article doesn't yet, but we're working on it! See more info or our list of citable articles.

Encyclopedia

From Wikipedia, the free encyclopedia

Giant cell tumor of the tendon sheath
Classification and external resources

Micrograph of pigmented villonodular synovitis. H&E stain.
ICD-9 727.02

Giant cell tumor of the tendon sheath (also known as "Giant cell synovioma," "Localized nodular tenosynovitis," and "Pigmented villonodular synovitis"[1]) is a firm lesion, measuring 1 to 3 cm in diameter, and is most commonly attached to the tendons of the fingers, hands, and wrists, with a predilection for the flexor surfaces.[2]:607[1] Giant cell tumor of tendon sheaths most often affect the wrist and fingers of males and females from the ages of 20-50 . These tumors are typically painless and can cause cortical erosion. Surgery to remove the tumor is a common treatment, though the tumors tend to recur.

Contents

Classification

Pigmented villonodular synovitis, described distinctly in 1941 by Charles J. Sutro, L. Lichtenstein, and H.L. Jafe,[3] comes in two forms: localized and diffuse. Diffuse PVNS affects the entire synovium and typically occurs in large joints such as the knee or hip. Localized, or nodular, PVNS is less common than the diffuse form and typically occurs in smaller joints such as the hands and feet. It often arises in the form of a benign giant cell tumor on the tendon sheaths of the joint.[4] As the tumor grows in the joint, it damages the surrounding bone and tissues.[5] Localized PVNS is predominantly found in females and is frequently found in the fingers. Although rare, localized PVNS may develop in large joints. In either case, the knee is the most commonly affected joint (80% of cases), followed by the hip, and less commonly the ankles and shoulders.[4] PVNS is generally found more in men than women.[6] It's also found in 1 out of two men and 1 out of 3 women.

Clinical presentation

In general, pigmented villonodular synovitis often manifests initially as sudden onset, unexplained joint swelling and pain; the joint swelling is disproportionate to the amount of pain the patient feels at first. Decreased motion and increased pain occur as the disorder progresses as well as locking of the joint. The localized form often manifests initially as a painless, slow-growing mass and progresses to the other common symptoms of PVNS. The swelling often feels warm to the touch.[4] Diffuse PVNS symptoms are often confused with those of Rheumatoid arthritis.[5] While pigmented villonodular synovitis can occur in both pediatric and geriatric patients, it is more common with ages 20–50.[4]

Complications

PVNS is locally aggressive and can spread to surrounding tissues, causing bone erosion and tissue damage. If not treated early, it can spread to areas outside the joint.[7] The disorder also has, on average, a 45% rate of recurrence.[3]

Diagnosis

Micrograph of PVNS showing pigmented hemosiderin-laden macrophages (brown/red). H&E stain.

PVNS is radiologically diagnosed by Magnetic Resonance Imaging (MRI). The disorder is difficult to identify and is often not diagnosed for four years or more after presentation due to nonspecific symptoms or a general paucity of symptoms.[3]

Advertisements

Pathology

The synovial fluid of the joint is often grossly hemorrhagic.[8]

PVNS, under the microscope, looks as the name of the condition suggests; it is composed on nodules and/or villi and has an abundant number of (pigmented) hemosiderin-laden macrophages.

Treatment

Once PVNS is confirmed by biopsy of the synovium of an affected joint, a synovectomy of the affected area is the most common treatment. Bone lesions caused by the disorder are removed and bone grafting is performed as needed. Because diffuse PVNS has a relatively high rate of recurrence, radiation therapy may be considered as a treatment option. In some cases, a total joint replacement is needed to relieve symptoms when PVNS causes significant joint destruction.[3]

See also

References

  1. ^ a b Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L. (2007). Dermatology: 2-Volume Set. St. Louis: Mosby. pp. 1820. ISBN 1-4160-2999-0.  
  2. ^ James, William; Berger, Timothy; Elston, Dirk (2005). Andrews' Diseases of the Skin: Clinical Dermatology. (10th ed.). Saunders. ISBN 0721629210.
  3. ^ a b c d Frassica FJ, Bhimani MA, McCarthy EF, Wenz J (October 1999). "Pigmented villonodular synovitis of the hip and knee". Am Fam Physician 60 (5): 1404–10; discussion 1415. PMID 10524485. http://www.aafp.org/afp/991001ap/1404.html.  
  4. ^ a b c d Pigmented Villonodular Synovitis at eMedicine
  5. ^ a b "Mayclinic". Mayo Clinic. http://www.mayoclinic.com/health/pigmented-villonodular-synovitis/AN01239. Retrieved 2007-07-15.  
  6. ^ "Family Doctor.org: PVNS" (web journal). http://familydoctor.org/online/famdocen/home/common/pain/disorders/469.html. Retrieved 2007-07-15.  
  7. ^ "Clinical Study" (web journal). The Stone Clinic. http://www.stoneclinic.com/PVNS.htm. Retrieved 2007-08-07.  
  8. ^ Aalberg JR, Hansen P. [Pigmented villonodular synovitis] Ugeskr Laeger. 1989 Sep 18;151(38):2413-6. Danish. PMID 2800012.

Pigmented villonodular synovitis
Classification and external resources
ICD-10 M12.2
ICD-9 719.20
DiseasesDB 29902
eMedicine radio/553 
MeSH D013586

Pigmented villonodular synovitis (PVNS) is a rare, benign condition that affects the synovium of joints, bursae, and tendon sheaths. The etiology, or cause, of this proliferative disorder is unknown. Two forms of the disorder exist: localized and diffuse, the latter being more common.

Contents

Classification

Pigmented villonodular synovitis, described distinctly in 1941 by Charles J. Sutro, L. Lichtenstein, and H.L. Jafe,[1] comes in two forms: localized and diffuse. Diffuse PVNS affects the entire synovium and typically occurs in large joints such as the knee or hip. Localized, or nodular, PVNS is less common than the diffuse form and typically occurs in smaller joints such as the hands and feet. It often arises in the form of a benign giant cell tumor on the tendon sheaths of the joint.[2] As the tumor grows in the joint, it damages the surrounding bone and tissues.[3] Localized PVNS is predominantly found in females and is frequently found in the fingers. Although rare, localized PVNS may develop in large joints. In either case, the knee is the most commonly affected joint (80% of cases), followed by the hip, and less commonly the ankles and shoulders.[2] PVNS is generally found more in men than women.[4]

Clinical presentation

In general, pigmented villonodular synovitis often manifests initially as sudden onset, unexplained joint swelling and pain; the joint swelling is disproportionate to the amount of pain the patient feels at first. Decreased motion and increased pain occur as the disorder progresses as well as locking of the joint. The localized form often manifests initially as a painless, slow-growing mass and progresses to the other common symptoms of PVNS. The swelling often feels warm to the touch.[2] Diffuse PVNS symptoms are often confused with those of Rheumatoid arthritis.[3] While pigmented villonodular synovitis can occur in both pediatric and geriatric patients, it is more common with ages 20–50.[2]

Complications

PVNS is locally aggressive and can spread to surrounding tissues, causing bone erosion and tissue damage. If not treated early, it can spread to areas outside the joint.[5] The disorder also has, on average, a 45% rate of recurrence.[1]

Diagnosis and treatment

PVNS is radiologically diagnosed by Magnetic Resonance Imaging (MRI). The disorder is difficult to identify and is often not diagnosed for four years or more after presentation due to nonspecific symptoms or a general paucity of symptoms.[1] Once PVNS is confirmed by biopsy of the synovium of an affected joint, a synovectomy of the affected area is the most common treatment. Bone lesions caused by the disorder are removed and bone grafting is performed as needed. Because diffuse PVNS has a relatively high rate of recurrence, radiation therapy may be considered as a treatment option. In some cases, a total joint replacement is needed to relieve symptoms when PVNS causes significant joint destruction.[1]

See also

References

  1. 1.0 1.1 1.2 1.3 Frassica FJ, Bhimani MA, McCarthy EF, Wenz J (October 1999). "Pigmented villonodular synovitis of the hip and knee". Am Fam Physician 60 (5): 1404–10; discussion 1415. PMID 10524485. http://www.aafp.org/afp/991001ap/1404.html. 
  2. 2.0 2.1 2.2 2.3 Pigmented Villonodular Synovitis at eMedicine
  3. 3.0 3.1 "Mayclinic". Mayo Clinic. http://www.mayoclinic.com/health/pigmented-villonodular-synovitis/AN01239. Retrieved on 2007-07-15. 
  4. "Family Doctor.org: PVNS" (web journal). http://familydoctor.org/online/famdocen/home/common/pain/disorders/469.html. Retrieved on 2007-07-15. 
  5. "Clinical Study" (web journal). The Stone Clinic. http://www.stoneclinic.com/PVNS.htm. Retrieved on 2007-08-07. 

Template:Diseases of the musculoskeletal system and connective tissue


Advertisements






Got something to say? Make a comment.
Your name
Your email address
Message