Pigmented Villonodular Synovitis (PVNS) Overview
Pigmented villonodular synovitis, or PVNS, is a disease caused by the abnormal growth of the hip joint’s lining tissue, known as the synovium. Excessive growth of this tissue leads to inflammation in the joint causing pain, tenderness, and stiffness. The condition occurs most commonly in patients in their 30s and 40s, but the actual cause of PVNS is still unknown. Individuals experiencing hip pain and other troublesome conditions are encouraged to contact Dr. Jeff Padalecki, Austin, Texas hip specialist, for a detailed physical examination, diagnosis and treatment plan.
PVNS is identified in two different forms:
- Localized – Pain and swelling occurs in just one area of the joint, and responds well to treatment.
- Diffuse – More common than localized PVNS, diffuse PVNS involves the entire joint, and can be more destructive and difficult to treat.
Pigmented Villonodular Synovitis (PVNS) Symptoms
Symptoms of PVNS include hip pain, weakness, and stiffness of the joint. Patients with localized PVNS may experience joint locking, a catching sensation or a feeling of instability. Patients with diffuse PVNS may experience a gradual onset in symptoms.
Pigmented Villonodular Synovitis (PVNS) Diagnostic Testing
PVNS may not necessarily be evident on a standard X-ray, though an X-ray could show other potential problems that could be causing the hip pain. Dr. Padalecki may choose to order an MRI scan that will more accurately show evidence of a nodular mass with bone changes if the condition is localized PVNS. If the condition is diffuse PVNS, an MRI will show a thickening of the joint lining or an extensive mass, potentially with destructive bone changes.
In some cases Dr. Padalecki may perform a procedure called a joint aspiration, whereby he releases fluid from the hip joint. Typically with PNVS cases, the joint fluid appears bloody. A biopsy is the confirmatory test for PVNS of the hip.
Pigmented Villonodular Synovitis (PVNS) Treatment
Surgery is the best option to treat a diagnosis of PVNS. Dr. Padalecki will remove the painful, inflamed synovial lining through a procedure called a synovectomy, which, can be done via arthroscopic or open surgery.
In an arthroscopic synovectomy, Dr. Padalecki surgically removes the affected lining with the mass only using small incisions. This is the most common way to treat localized PVNS. However in the instance of diffuse PVNS, a total synovectomy may be required, which is an open surgery procedure that removes the mass and the entire joint lining.
Following a synovectomy, patients should avoid full weight bearing as discussed with Dr. Padalecki at the first post-operative visit. For patients recovering from arthroscopic procedures, the recovery time is shorter, and will involve a short course of physical therapy before resuming normal daily activities. However for those who undergo the open procedure, a more extensive physical therapy program will be prescribed to prevent post-op stiffness and a return to normal mobility, often taking months.
For more information on PVNS (pigmented villonodular synovitis) or other disorders of the hip, please contact the office of Dr. Jeff Padalecki, hip specialist in Austin, Texas.