Pigmented Villonodular Synovitis (PVNS): Symptoms, Diagnosis and Treatment in Pune
Pigmented villonodular synovitis, usually called PVNS, is a condition in which the lining of a joint becomes thick and swollen. It is usually not cancerous, but it can cause pain, stiffness and repeated swelling in the joint. Treatment aims to control the swelling and protect the joint.
This guide explains what PVNS is, the signs to watch for, how it is diagnosed, the treatment options, and what rehabilitation and follow-up look like. It is written for patients in Pune, including Kothrud, Hinjewadi, Wakad and Pimpri-Chinchwad, who want clear information before a consultation.
What is pigmented villonodular synovitis?
The synovium is the thin membrane that lines a joint. It produces the fluid that keeps the joint moving smoothly. In PVNS, this lining grows abnormally and becomes thick, swollen and fragile.
The lining contains small blood vessels, so it can bleed into the joint. Over time, deposits of iron from old bleeding can build up, which gives the condition its name. The growth itself has a villous (finger-like) and nodular pattern.
Localized and diffuse forms
PVNS is usually described in two forms:
Localized: the thickened lining is confined to one small area of the joint, often as a single nodule.
Diffuse: the lining is affected across much of the joint, which may need a more extensive treatment.
The knee is the joint most often affected. PVNS can also affect the hip, ankle and shoulder.
Signs and symptoms
PVNS often starts slowly, and symptoms can come and go. Common signs include:
Swelling in the joint that may return again and again
Pain, especially with activity
Stiffness and reduced range of movement
A feeling of locking, catching or the joint giving way
Bloody or dark joint fluid during a repeated swelling
Many other joint conditions can look similar, so a proper examination is important before any conclusion is drawn.
How is PVNS diagnosed?
Diagnosis usually follows a few steps:
Clinical examination. The surgeon checks the swelling, movement, stability and the areas of pain.
X-ray. Plain X-rays help rule out other causes and show any changes in the bone next to the joint.
MRI scan. MRI is the main imaging test. It shows the thickened lining and the iron deposits from old bleeding, which appear as dark areas on certain scan sequences.
Joint aspiration. A small amount of fluid may be drawn from the joint to examine it and rule out infection or other conditions.
Biopsy. A small sample of the lining is examined under a microscope to confirm the diagnosis.
Treatment options for PVNS
The right treatment depends on where the condition is, how far it has spread, the state of the joint, and your general health. Your surgeon explains each option and what it involves.
Synovectomy
Synovectomy means removing the inflamed lining of the joint. It can be done arthroscopically, through small keyhole incisions with a camera, or as an open operation when the lining is more extensive or hard to reach.
Staged or combined approaches
Some patients need more than one step. A surgeon may plan a staged approach, or combine techniques in one operation, to clear the joint thoroughly. The plan is always made for the individual patient.
Radiotherapy and targeted medicines in selected cases
In selected cases, radiotherapy or targeted medicines may be considered, particularly when surgery is not suitable or the condition keeps returning. These options are used with care and discussed in detail with the patient.
Joint replacement for advanced joint damage
If PVNS has damaged the joint surface over time, joint replacement may be discussed. This is considered when the joint is badly affected and other treatments are not enough.
Recurrence and follow-up
PVNS can come back after treatment, particularly in the diffuse form. Regular follow-up with clinical review and imaging allows returning symptoms to be checked early. Your surgeon will explain the follow-up plan that suits you.
Rehabilitation and recovery
Rehabilitation is an important part of recovery. Physiotherapy usually starts as early as is safe, with a focus on regaining movement, easing the swelling and rebuilding strength around the joint. Recovery is gradual, and the pace differs from person to person.
Your physiotherapist will set exercises and goals with you, and will explain which activities to avoid while the joint heals.
When to see an orthopedic doctor
See an orthopedic doctor if you have:
Joint swelling that keeps returning or does not settle
Pain or stiffness that limits daily activities
A joint that locks, catches or gives way
Bloody or dark fluid from the joint
A lump near a joint that is growing or causing discomfort
Seek urgent medical care if a joint suddenly becomes very hot, red and painful with fever, or if you cannot bear weight on a leg after an injury.
Book a consultation in Pune
Dr Sunny Dole is an orthopedic trauma and joint replacement surgeon at Kothrud Orthopedic Clinic, Office 401, Success Square CHS, Karve Road, Kothrud, Pune 38. Please book an appointment through the website to confirm timings.
Book a consultation: www.sunnydole.com
This article is for general education. It is not medical advice and does not replace an examination by a doctor. If you have an injury or a joint problem, please see a qualified orthopedic doctor.
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