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Pigmented villonodular synovitis

What causes pigmented villonodular synovitis?

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Mayo Clinic rheumatologist April Chang-Miller, M.D., and colleagues answer select questions from readers.


Pigmented villonodular synovitis (PVNS) is a rare joint disorder involving a noncancerous tumor that originates in the tissue lining the joints (synovial tissue). As the tumor grows, it damages the bone surrounding the joint. It may also cause excess fluid in the joint, resulting in pain and swelling. The cause of pigmented villonodular synovitis isn't known. It may be an inflammatory response, although the "trigger" hasn't been identified. It may also result from trauma or injury to the joint.

There are several types of pigmented villonodular synovitis:

  • Pigmented villonodular tenosynovitis (PVTS), also called giant cell tumor of the tendon sheath. PVTS usually affects the finger joints and occurs most often in women between the ages of 20 and 40.
  • Localized pedunculated villonodular synovitis (LPVS). This type typically involves the knee causing a locking or clicking sensation in the joint.
  • Diffuse pigmented villonodular synovitis. Diffuse PVNS tends to affect the knee but may also affect the hip or ankle. This type can mimic rheumatoid arthritis.

A doctor may confirm a diagnosis of pigmented villonodular synovitis by biopsy. Treatment may include surgical removal of the affected synovial tissue (synovectomy). However, this disorder may recur.

Jun 9, 2007