# Pigmented villonodular synovitis (PVNS)



## Red (Feb 16, 2010)

So, I'm currently undergoing tests for this as I have suspected symptoms on my right knee (as well as an unrelated torn cartilage which might need surgery). Kind of scared and kind of ignorant as I have no idea of what the hell it all means. Does anyone here have any knowledge of this joint problem?

I'm currently waiting for a second MRI but this time with gadolinium (also unsure of this process if anyone has any experience?) which I'm having this Thursday and then an appointment with an orthopaedic surgeon to discuss the long term stuff. They're not too sure if I have it yet as it's apparently stupidly rare but I want to arm myself with knowledge just incase.

Thank you.


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## Fat.n.sassy (Feb 16, 2010)

Red said:


> So, I'm currently undergoing tests for this as I have suspected symptoms on my right knee (as well as an unrelated torn cartilage which might need surgery). Kind of scared and kind of ignorant as I have no idea of what the hell it all means. Does anyone here have any knowledge of this joint problem?
> 
> I'm currently waiting for a second MRI but this time with gadolinium (also unsure of this process if anyone has any experience?) which I'm having this Thursday and then an appointment with an orthopaedic surgeon to discuss the long term stuff. They're not too sure if I have it yet as it's apparently stupidly rare but I want to arm myself with knowledge just incase.
> 
> Thank you.



Howdy Red,

I just Googled PVNS, you must be uncomfortable. The site I got the most concise information was http://familydoctor.org/online/famdocen/home/common/pain/disorders/469.html[/URL] If this link doesn't work, the site is TheFamilyDoctor.org, search PVNS. 

Best of luck to you! Please let us know what happens on Thursday!
(((Hugs))) Viv


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## ThatFatGirl (Feb 17, 2010)

It sounds painful and the whole experience scary, Red. I'm sorry you're going through this and hope you find the answers and comfort you're seeking soon. Good luck!


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## Red (Feb 17, 2010)

Thanks lovelies, I went to the rheumatology clinic today and had a load of tests done, general consensus is that if I _don't_ which is unlikely, have PVNS, I have some sort of inflammatory arthritis as I have lots of fluid on my knee so either way it looks like I will be needing surgery 

I will keep y'all posted


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## Fat.n.sassy (Feb 17, 2010)

Red said:


> Thanks lovelies, I went to the rheumatology clinic today and had a load of tests done, general consensus is that if I _don't_ have PVNS, I have some sort of inflammatory arthritis as I have lots of fluid on my knee so either way it looks like I will be needing surgery
> 
> I will keep y'all posted



I don't know how you feel about stuff like this, but if you don't mind, I'll be praying for you.


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## toni (Feb 17, 2010)

That sucks, RED! I will be hoping the best for you.


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## Red (Feb 19, 2010)

Thanks everyone. So, I had the MRI with Gadolinium yesterday, it wasn't pleasant as the nurse had trouble finding a vein and poked at me 4 times and I got a bit weepy. I was also in the machine for quite a long time (over an hour) with my knee locked down so I left feeling pretty sore. I should find out the results next week though and shall keep you posted.


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## moore2me (Feb 19, 2010)

Dear Red,

I read where you have already had your MRI test with Gadolinium. I have periodic brain scans with "Gad" (every 2 yrs) and there's appears to be no lasting problems from the injection of the dye into our bloodstream. It is eliminated by our bodies in a short amount of time. And having an MRI of my brain actually makes my headaches stop and my mood improves for a week or two after the test It kind of temporarily rearranges the particles or electrical charges up there or something ??? 

However, I don't like the idea of getting poked 4 times to inject dye or start an IV line or other in-vein stuff. If someone like me has bad veins and is hard to stick, we need to protect our injection sites. We don't need them scarred up by a bunch of needle stabs by newbies who are not used to sticking people that are hard to find a vein on. From now on, I would start telling nurses or techs or docs that you are hard to stick and you need someone to poke you that is really good and use a baby syringe. Ask for the best blood drawing person in the office to stick you. Don't be shy.

In the MRI, I ask for something to calm me down before I go in. If I have pain, that pain should be medicated before you go in and have to keep the injured part still for an hour. This could be done by giving you a shot in the knee as a local, an oral general pain pill, or some IV medication as general pain meds. #2 and #3 will require you to have a driver to go home. #1 may require special mods if you cannot walk after wards or need to operated a brake or a accelerator on a car.

I will look up the condition you are being tested for and will post more later.


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## moore2me (Feb 22, 2010)

Red,
I included some definitions at the bottom of these two paragraphs. I hope you don't have anything seriously wrong with your knee, But the syndrome you mentioned seems treatable (I am not a doctor). It seems to be more easily treated the earlier it is diagnosed. Good luck. Having had one knee worked on myself (laproscopically) my best advice is to exercise it and keep ice on the injury. Exercise allows you to build up extra muscle power to help support the injured site. Ice keeps the swelling down. And follow the doctor's orders.
*
From Merck &#8211; Tumors of Bones and Joints* 
(I could not get the link to work. Will try later. Sorry.)

*Pigmented Villonodular Synovitis*—occurs in the lining (synovium) of joints. The tumors are benign but locally aggressive. . . . (usually one joint is affected), most often the knee and second most often the hip, and can cause pain and effusion. Both are treated by synovectomy and removal of any intra-articular bodies.

Pigmented villonodular synovitis is considered neoplastic. The synovium becomes thickened and contains hemosiderin, which gives the tissue its blood-stained appearance and characteristic appearance on MRI. This tissue tends to invade adjacent bone, causing cystic destruction and damage to the cartilage. Pigmented villonodular synovitis is usually monarticular but may be polyarticular. Late management, especially after recurrence, may require total joint replacement. On rare occasions after several synovectomies, radiation therapy can be used.

From a medical dictionary at http://www.nlm.nih.gov/medlineplus/mplusdictionary.html

Effusion - effusion the escape of a fluid from anatomical vessels by rupture or exudation (oozing) 

Synovectomy - surgical removal of a synovial membrane.
intra-articular - situated within, occurring within, or administered by entering a joint. 

Neoplastic - of or relating to a new growth of tissue serving no physiological function, a tumor, Moore’s note: However, not all tumors are malignant. Some are benign as in cysts, moles, or birthmark skin stains.

Hemosiderin - a yellowish brown granular pigment formed by breakdown of hemoglobin, found in phagocytes and in tissues especially in disturbances of iron metabolism (as in hemochromatosis, hemosiderosis, or some anemias), and composed essentially of colloidal ferric oxide -- compare FERRITIN 

Cystic &#8211; relating to a cyst . A cyst is a a closed sac having a distinct membrane and developing abnormally in a body cavity or structure.

Monarticular - affecting only one joint of the body.

Polyarticular - having or affecting many joints.


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## Shosh (Feb 22, 2010)

Red said:


> So, I'm currently undergoing tests for this as I have suspected symptoms on my right knee (as well as an unrelated torn cartilage which might need surgery). Kind of scared and kind of ignorant as I have no idea of what the hell it all means. Does anyone here have any knowledge of this joint problem?
> 
> I'm currently waiting for a second MRI but this time with gadolinium (also unsure of this process if anyone has any experience?) which I'm having this Thursday and then an appointment with an orthopaedic surgeon to discuss the long term stuff. They're not too sure if I have it yet as it's apparently stupidly rare but I want to arm myself with knowledge just incase.
> 
> Thank you.



I am sorry to hear this Red. I am unfamiliar with this condition. I am sure your surgeon will be able to give you pretty comprehensive information regarding the condition.

As for the gadolinium, well I have it when I have an MRI's of my brain annually. It is just a dye that is injected that helps to show up the minute detail in scans. They can get a better picture of what is happening, and if there has been any disease progress.


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## Red (May 31, 2010)

So, I definitely have PVNS and I am going in for keyhole surgery on June 17th. The doctor I spoke to said it's a pretty severe case but I'm lucky to be diagnosed so quickly because it usually takes a while to be fully identified. 

The operation will be to trim a small cartilage tear in the knee (unrelated injury) and to remove the PVNS tumour that is also present, and do a biopsy. When I measure my knee it is about 1" fatter than the other so there is a lot of fluid in there so hopefully after this I will be able to straighten my leg fully and kneel and put pressure on the knee. It's very annoying being unable to do something as simple as kneel/sit on the floor.

I asked if it was caused by weight and the Dr said although my current weight doesn't help the situation, PVNS is just 'one of those things' and no one is quite sure yet what actually causes it. I have read a lot of forums though and one thing that seemed common was that the discovery of the tumour is 'brought on' by a simple unrelated injury - this rings true with me, bashing my knee and a week or so later being unable to kneel on it. Maybe it's the body's reaction to the injury? Who really knows? Here's hoping the fucker doesn't come back. Keep y'all posted x


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## moore2me (Jun 1, 2010)

Dear Red,

I hope your surgery turns out well and your recovery is quick. I will be praying for you and your doctor and nurses. Are you going to have it on an outpatient basis? How are you fixed at home for the recovery period? Do you have help? Do you live on a bottom story? Are there stairs? Can you take off work? Etc?


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## MuleVariationsNYC (Jun 5, 2010)

Hey Red- 

Just saw this thread. Good luck to you in your upcoming surgery. I'm sure it will go well.


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## Fat.n.sassy (Jun 24, 2010)

Hi Red,

How is everything? I hope you're up and "running"! Thanks also for the info about gadolinium (sp?) I'm having an MRI with and without to rule out MS. It's good to know what it's like. Thanks.


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