Pigment Villonodular Synovitis of the Hip

• synonyms: PNVS
• ICD-9
• uncommon disease.  Hip involved 15% of the time
• pathogenesis unknown

PVNS Clinical Evaluation

• insidious onset of pain and limited ROM

PVNS Xray

• cortical erosions in the acetabulum, femoral neck, and margins of the femoral head.  Often seen as cyst like structures on A/P xray
• MRI indicated.  Typically shows intra-articular effusion, low signal intensity on both T1 and T2 images due to hemosiderin deposition and thick fibrous tissue, synovial hyperplasia, bone ersosions, and preservation of bone density and joint space width. 

PVNS Treatment

• synovectomy

PVNS Follow-up

• comlete synovectomy is effective in preventing recurrence of synovitis, but does not prevent development of secondary arthritis

PVNS References:

• Vastel L, JBJS 2005;87A;101924